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General NPI Number Information
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NPI Number | 1508217993
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Entity Type | Individual
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Provider Name | ALI MUMTAZ D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2016
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 8556 FORT SMALLWOOD RD
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City | PASADENA
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State | MD
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Zip | 21122-2634
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Country | US
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Telephone | 410-255-1190
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Fax | 410-255-1484
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Provider Business Mailing Address
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Address Line | 4660 WILKENS AVE STE 202
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City | BALTIMORE
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State | MD
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Zip | 21229-4846
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Country | US
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Telephone | 410-242-7066
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Fax | 410-242-4126
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | LL9771
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License Number State | MD
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