Healthcare Provider Details

I. General information

NPI: 1437293966
Provider Name (Legal Business Name): SULTANA JAHAN AFROOZ D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2007
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8808 CENTRE PARK DR STE 301
COLUMBIA MD
21045-2224
US

IV. Provider business mailing address

8808 CENTRE PARK DR STE 301
COLUMBIA MD
21045-2224
US

V. Phone/Fax

Practice location:
  • Phone: 301-970-9724
  • Fax:
Mailing address:
  • Phone: 301-970-9724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberH67624
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS012862
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: