Healthcare Provider Details

I. General information

NPI: 1679000384
Provider Name (Legal Business Name): NIMRAH A HOSSAIN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NIMRAH A AHMED D.O.

II. Dates (important events)

Enumeration Date: 05/12/2017
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9701 APOLLO DR STE 200
LARGO MD
20774-4794
US

IV. Provider business mailing address

8116 GOOD LUCK RD STE 305
LANHAM MD
20706-3508
US

V. Phone/Fax

Practice location:
  • Phone: 301-552-1200
  • Fax: 301-552-1202
Mailing address:
  • Phone: 301-552-1200
  • Fax: 301-552-1202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberH0107194
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberH0107194
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: