Healthcare Provider Details

I. General information

NPI: 1427143536
Provider Name (Legal Business Name): MOHSIN ANSARI MD FAAP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

7001 JOHNNYCAKE RD SUITE # 102
WINDSOR MILL MD
21244-2418
US

V. Phone/Fax

Practice location:
  • Phone: 410-744-5437
  • Fax: 410-744-5436
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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier407361400
Identifier TypeMEDICAID
Identifier StateMD
Identifier Issuer
# 2
Identifier407361401
Identifier TypeMEDICAID
Identifier StateMD
Identifier Issuer

VIII. Authorized Official

Name: MOHSIN ANSARI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 410-744-5437