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General NPI Number Information
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NPI Number | 1790925493
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Entity Type | Individual
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Provider Name | MARIAM RAZAQ D.O.
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Gender | Female
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Dates
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Enumeration Date | 02/20/2009
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Last Update Date | 04/08/2022
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Provider Practice Location Address
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Address Line | 601 POST OFFICE RD STE 2A
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City | WALDORF
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State | MD
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Zip | 20602-1912
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Country | US
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Telephone | 240-754-7954
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Fax | 240-754-7958
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Provider Business Mailing Address
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Address Line | 601 POST OFFICE RD STE 2A
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City | WALDORF
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State | MD
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Zip | 20602-1912
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Country | US
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Telephone | 240-754-7954
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Fax | 240-754-7958
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | DO034267
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | H0067340
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License Number State | MD
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