Organization Active NPI

Mid-Atlantic Institute of Venous and Lymphatic Medicine LLC

  • Phlebology Physician
  • Elkton, MD
National Provider Identifier
1225588569
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebology PhysicianTaxonomy code 202K00000X
Legal business name
MID-ATLANTIC INSTITUTE OF VENOUS AND LYMPHATIC MEDICINE LLC
Practice address
677 E Pulaski Hwy Ste 1B
Elkton, MD 21921-6057
Phone
(410) 398-0215
Fax
(443) 593-3725
NPI assigned
Oct 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mohammad Basit Afzal, MD, RPVI
Title
Provider
Phone
(410) 398-0215

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 202K00000X Primary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X MD

Addresses

Primary practice location

677 E Pulaski Hwy Ste 1B
Elkton, MD 21921-6057

Mailing address

677 E Pulaski Hwy Ste 1B
Elkton, MD 21921-6057
Phone (410) 398-0215

National Provider Directory

National Provider Directory

Locations

300 E Pulaski Hwy
Ste 101B
Elkton, MD 21921

137 W Main St
Elkton, MD 21921
Phone (410) 392-8182

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692835200000",
    "number": "1225588569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 E PULASKI HWY STE 1B",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219216057",
            "telephone_number": "410-398-0215",
            "fax_number": "443-593-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 E PULASKI HWY STE 1B",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219216057",
            "telephone_number": "410-398-0215",
            "fax_number": "443-593-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-ATLANTIC INSTITUTE OF VENOUS AND LYMPHATIC MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-11",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A",
        "authorized_official_last_name": "AFZAL",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "BASIT",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "410-398-0215",
        "authorized_official_credential": "MD, RPVI"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Phlebology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.