Healthcare Provider Details

I. General information

NPI: 1710182498
Provider Name (Legal Business Name): SHAFQUAT MERAJ, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 PRINCE FREDERICK BOULEVARD
PRINCE FREDERICK MD
20678-4019
US

IV. Provider business mailing address

PO BOX 447
PRINCE FREDERICK MD
20678-0447
US

V. Phone/Fax

Practice location:
  • Phone: 410-231-4666
  • Fax: 410-414-8480
Mailing address:
  • Phone: 410-535-4116
  • Fax: 410-414-8480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD0060084
License Number StateMD

VIII. Authorized Official

Name: DR. SHAFQUAT MERAJ
Title or Position: OWNER
Credential: M.D.
Phone: 410-231-4666