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General NPI Number Information
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NPI Number | 1891107058
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Entity Type | Organization
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Legal Business Name | THE NEUROLOGY INSTITUTE FOR BRAIN HEALTH AND FITNESS
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Dates
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Enumeration Date | 05/22/2014
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Last Update Date | 05/22/2014
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Provider Practice Location Address
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Address Line | 10700 CHARTER DR 210A
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City | COLUMBIA
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State | MD
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Zip | 21044-3629
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Country | US
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Telephone | 443-842-6333
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Fax | 410-992-1642
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Provider Business Mailing Address
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Address Line | 10700 CHARTER DR 210A
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City | COLUMBIA
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State | MD
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Zip | 21044-3629
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Country | US
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Telephone | 443-842-6333
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Fax | 410-992-1642
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MAJID FOTUHI
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Credential | MD
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Telephone | 410-494-0191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | D0059507
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License Number State | MD
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