Healthcare Provider Details

I. General information

NPI: 1366456675
Provider Name (Legal Business Name): HASHIM S. HASHIM, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 RANDOLPH RD SUITE 212
ROCKVILLE MD
20852-2257
US

IV. Provider business mailing address

4701 RANDOLPH RD SUITE 212
ROCKVILLE MD
20852-2257
US

V. Phone/Fax

Practice location:
  • Phone: 240-221-0141
  • Fax: 240-221-0143
Mailing address:
  • Phone: 240-221-0141
  • Fax: 240-221-0143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0052219
License Number StateMD

VIII. Authorized Official

Name: HASHIM SHAMSALDIN HASHIM
Title or Position: PRESIDENT
Credential: M.D.
Phone: 240-221-0141