Healthcare Provider Details

I. General information

NPI: 1700106200
Provider Name (Legal Business Name): YOUSAF AWAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2010
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 W BELVEDERE AVE
BALTIMORE MD
21215-5216
US

IV. Provider business mailing address

1365 BOYLSTON ST UNIT #252
BOSTON MA
02215-3912
US

V. Phone/Fax

Practice location:
  • Phone: 410-601-5201
  • Fax: 410-601-9481
Mailing address:
  • Phone: 443-527-1984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC7-0004574
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberD75440
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD047832
License Number StateDC
# 5
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberD0075440
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: