Healthcare Provider Details

I. General information

NPI: 1952072555
Provider Name (Legal Business Name): SHAJEEN UDDIN AKTHER MSPAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2021
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1838 GREENE TREE RD STE 340
PIKESVILLE MD
21208-7116
US

IV. Provider business mailing address

151 SOUTHHALL LN STE 300
MAITLAND FL
32751-7172
US

V. Phone/Fax

Practice location:
  • Phone: 410-602-3376
  • Fax: 410-602-7954
Mailing address:
  • Phone: 239-465-4916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberC0008220
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: