Healthcare Provider Details

I. General information

NPI: 1639333644
Provider Name (Legal Business Name): MARIAM HAMEED MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2008
Last Update Date: 07/01/2022
Certification Date: 07/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 KNOLL NORTH DR STE 500
COLUMBIA MD
21045
US

IV. Provider business mailing address

1300 4TH ST SE UNIT 204
WASHINGTON DC
20003-2569
US

V. Phone/Fax

Practice location:
  • Phone: 410-571-2946
  • Fax:
Mailing address:
  • Phone: 443-204-4919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberMD042568
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberMD042568
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberD80728
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberMD042568
License Number StateDC
# 5
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberD80728
License Number StateMD
# 6
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberD80728
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: