Healthcare Provider Details

I. General information

NPI: 1164451027
Provider Name (Legal Business Name): SYED SALMAN ASHRUF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 12/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 CRAIN HWY S SUITE 509
GLEN BURNIE MD
21061-5577
US

IV. Provider business mailing address

1301 LINCOLN WOODS DR
BALTIMORE MD
21228-2531
US

V. Phone/Fax

Practice location:
  • Phone: 410-590-4313
  • Fax: 410-590-4314
Mailing address:
  • Phone: 410-747-3534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberD0063061
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License NumberD0063061
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: