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General NPI Number Information
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NPI Number | 1629482492
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Entity Type | Individual
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Provider Name | MAZIN MERDAD
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Gender | Male
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Dates
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Enumeration Date | 06/19/2014
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Last Update Date | 06/19/2014
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Provider Practice Location Address
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Address Line | 601 N CAROLINE ST JOHNS HOPKINS OUTPATIENT CENTER
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City | BALTIMORE
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State | MD
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Zip | 21287-0006
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Country | US
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Telephone | 410-955-6420
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Fax |
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Provider Business Mailing Address
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Address Line | 35 HAYDEN ST APT 2802
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City | TORONTO
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State | ON
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Zip | M4Y3C3
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Country | CA
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Telephone |
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Fax |
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 999999
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License Number State | MD
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