Healthcare Provider Details

I. General information

NPI: 1730945981
Provider Name (Legal Business Name): MOHSIN ANSARI MD FAAP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2024
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 S SCHUMAKER DR UNIT A
SALISBURY MD
21804-8708
US

IV. Provider business mailing address

7001 JOHNNYCAKE RD STE 102
WINDSOR MILL MD
21244-2419
US

V. Phone/Fax

Practice location:
  • Phone: 410-742-2255
  • Fax: 410-742-2589
Mailing address:
  • Phone: 410-744-5437
  • Fax: 410-744-5436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MOHSIN ANSARI
Title or Position: OWNER OF ENTITY
Credential:
Phone: 410-744-5437