Healthcare Provider Details

I. General information

NPI: 1902549595
Provider Name (Legal Business Name): AMREEN S AZIZ MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2022
Last Update Date: 04/20/2022
Certification Date: 04/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S CENTER ST
THURMONT MD
21788-1945
US

IV. Provider business mailing address

100 S CENTER ST
THURMONT MD
21788-1945
US

V. Phone/Fax

Practice location:
  • Phone: 301-271-4333
  • Fax: 301-271-7486
Mailing address:
  • Phone: 301-271-4333
  • Fax: 301-271-7486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AMREEN SAJJAD AZIZ
Title or Position: PRESIDENT
Credential: MD
Phone: 301-440-8604