Healthcare Provider Details

I. General information

NPI: 1316934755
Provider Name (Legal Business Name): SYED MOHIUDDIN KARIM M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8450 DORSEY RUN RD C.T. PERKINS HOSPITAL CENTER
JESSUP MD
20794-9486
US

IV. Provider business mailing address

7224 ANTARES DR
GAITHERSBURG MD
20879-5427
US

V. Phone/Fax

Practice location:
  • Phone: 410-724-3150
  • Fax: 410-724-3159
Mailing address:
  • Phone: 301-947-2470
  • Fax: 301-947-2470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberD0053032
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: