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General NPI Number Information
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NPI Number | 1578959615
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE ONCOLOGY AND HEMATOLOGY CENTER LLC
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Dates
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Enumeration Date | 04/14/2015
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Last Update Date | 04/21/2023
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Provider Practice Location Address
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Address Line | 2405 WHITTIER DR UNIT 100
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City | FREDERICK
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State | MD
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Zip | 21702-3361
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Country | US
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Telephone | 301-682-2988
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Fax | 301-682-2989
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Provider Business Mailing Address
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Address Line | 2405 WHITTIER DR UNIT 100
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City | FREDERICK
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State | MD
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Zip | 21702-3361
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Country | US
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Telephone | 16-822-9883
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Fax | 301-682-2989
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Authorized Official
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Title or Position | OWNER
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Name | MOUHAMAD BAZZI
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Credential | M.D.
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Telephone | 301-682-2988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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