Healthcare Provider Details
I. General information
NPI: 1912954314
Provider Name (Legal Business Name): METRO INFECTIOUS DISEASE CONSULTANTS ,PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/30/2006
Last Update Date: 06/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10110 MOLECULAR DRIVE SUITE 105
ROCKVILLE MD
20850
US
IV. Provider business mailing address
10110 MOLECULAR DRIVE SUITE 105
ROCKVILLE MD
20850
US
V. Phone/Fax
- Phone: 301-605-7468
- Fax: 301-605-7469
- Phone: 301-605-7468
- Fax: 301-605-7469
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SAMEH
A
ALY
Title or Position: OWNER/MANAGER
Credential: MD
Phone: 301-605-7468