Anas Abdullah

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Baltimore, MD

NPI 1184040917 · NPPES record last updated Mar 18, 2014

Key facts

NPI
1184040917
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
4940 Eastern Ave
Baltimore, MD 21224-2735
Phone
(410) 550-0886
NPI assigned
Mar 18, 2014
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20140707000797 MD Order and Referring Only - Plastic and Reconstructive Surgery
Practitioner - Plastic and Reconstructive Surgery
0547485591

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

4940 Eastern Ave
Baltimore, MD 21224-2735

Mailing address

4940 Eastern Ave
Baltimore, MD 21224-2735
Phone (410) 550-0886

Other providers in Baltimore, MD

All providers in Baltimore, MD · Student in an Organized Health Care Education/Training Program in Maryland

Sources for this page

Verify at the official NPI Registry.