Healthcare Provider Details

I. General information

NPI: 1699741736
Provider Name (Legal Business Name): BASHIR ZIKRIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10753 FALLS RD
LUTHERVILLE MD
21093-4535
US

IV. Provider business mailing address

6201 GREENLEIGH AVENUE
BALTIMORE MD
21264-4664
US

V. Phone/Fax

Practice location:
  • Phone: 410-583-2950
  • Fax:
Mailing address:
  • Phone: 410-933-6423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberME0093661
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberD64807
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: