MEDICARE: BASHARAT JABEEN AZIZ MD PA

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	174400000X	Specialist	D21644	MD

General Provider Information

NPI Number	:	1861642746
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BASHARAT JABEEN AZIZ MD PA

Provider Business Mailing Address
First Line	:	7505 OSLER DR
Second Line	:	SUITE 203
City	:	TOWSON
State	:	MD
Zip	:	21204-7737
Country	:	US
Telephone Number	:	410-823-1150
Fax Number	:	410-825-1636

Provider Business Practice Location Address
First Line	:	7505 OSLER DR
Second Line	:	SUITE 203
City	:	TOWSON
State	:	MD
Zip	:	21204-7737
Country	:	US
Telephone Number	:	410-823-1150
Fax Number	:	410-825-1636

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BASHARAT JABEEN AZIZ
Credential	:	MD PA
Telephone Number	:	410-823-1150

Provider Enumeration Date	:	09/26/2008
Last Update Date	:	10/02/2008

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