Healthcare Provider Details
I. General information
NPI: 1841247434
Provider Name (Legal Business Name): HADEEL NAQIB,M.D.,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1232 RACE RD SUITE 201
BALTIMORE MD
21237-2351
US
IV. Provider business mailing address
1232 RACE RD SUITE 201
BALTIMORE MD
21237-2351
US
V. Phone/Fax
- Phone: 410-687-6434
- Fax: 410-687-9855
- Phone: 410-687-6434
- Fax: 410-687-9855
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | D0041989 |
| License Number State | MD |
VIII. Authorized Official
Name: DR.
HADEEL
ISSA
NAQIB
Title or Position: PRESIDENT
Credential: M.D.
Phone: 410-687-6434