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General NPI Number Information
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NPI Number | 1346304060
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Entity Type | Individual
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Provider Name | MARIAM H BAKIR NP
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Gender | Female
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 100 BROOKSBY VILLAGE DR
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City | PEABODY
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State | MA
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Zip | 01960-1438
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Country | US
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Telephone | 978-536-7850
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Fax | 978-536-7851
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Provider Business Mailing Address
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Address Line | 5730 EXECUTIVE DR STE 230
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City | CATONSVILLE
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State | MD
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Zip | 21228-1762
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Country | US
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Telephone | 978-536-7850
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Fax | 978-536-7851
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | R150259
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | RN10003198
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License Number State | MA
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