Healthcare Provider Details

I. General information

NPI: 1538343140
Provider Name (Legal Business Name): NAJIAH FAOUR D.P.M
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 BLENHIEM FARM LN STE C
HAVRE DE GRACE MD
21078-2042
US

IV. Provider business mailing address

1 N MAIN ST
BEL AIR MD
21014-3592
US

V. Phone/Fax

Practice location:
  • Phone: 410-939-0055
  • Fax:
Mailing address:
  • Phone: 410-879-1212
  • Fax: 410-803-1859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC005976
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number01519
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number1841
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number01519
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: