Healthcare Provider Details

I. General information

NPI: 1518596261
Provider Name (Legal Business Name): AHAD MUSSARAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2020
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6535 N CHARLES ST STE 220
BALTIMORE MD
21204-5823
US

IV. Provider business mailing address

6535 N CHARLES ST STE 220
BALTIMORE MD
21204-5823
US

V. Phone/Fax

Practice location:
  • Phone: 443-849-7246
  • Fax: 443-849-4868
Mailing address:
  • Phone: 443-849-7246
  • Fax: 443-849-4868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberD0097810
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: