Healthcare Provider Details

I. General information

NPI: 1740816537
Provider Name (Legal Business Name): AMERICAN PSYCHIATRIC GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2020
Last Update Date: 03/12/2020
Certification Date: 03/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10632 LITTLE PATUXENT PKWY STE 104
COLUMBIA MD
21044-6217
US

IV. Provider business mailing address

9638 MAYMONT DR
VIENNA VA
22182-3010
US

V. Phone/Fax

Practice location:
  • Phone: 410-446-5461
  • Fax:
Mailing address:
  • Phone: 410-446-5461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: IRFAN SAEED
Title or Position: OWNER
Credential: MD
Phone: 410-599-9977