Healthcare Provider Details

I. General information

NPI: 1336135979
Provider Name (Legal Business Name): ASGHAR SHAIGANY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 04/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5632 ANNAPOLIS RD #12
BLADENSBURG MD
20710-2213
US

IV. Provider business mailing address

5632 ANNAPOLIS RD #12
BLADENSBURG MD
20710-2213
US

V. Phone/Fax

Practice location:
  • Phone: 301-864-3888
  • Fax: 301-699-3007
Mailing address:
  • Phone: 301-864-3888
  • Fax: 301-699-3007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberB94178
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD12938
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: