MEDICARE: DR. HUSNA BAKSH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	D0043436	MD
2	207R00000X	Internal Medicine Physician	D0043436	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740396092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HUSNA BAKSH M.D.

Provider Business Mailing Address
First Line	:	10750 COLUMBIA PIKE
Second Line	:	SUITE 401
City	:	SILVER SPRING
State	:	MD
Zip	:	20901-4402
Country	:	US
Telephone Number	:	301-593-6072
Fax Number	:	866-382-1197

Provider Business Practice Location Address
First Line	:	10750 COLUMBIA PIKE
Second Line	:	SUITE 401
City	:	SILVER SPRING
State	:	MD
Zip	:	20901-4402
Country	:	US
Telephone Number	:	301-593-6072
Fax Number	:	866-382-1197

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	04/26/2017

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