Organization Active NPI

Fmca PA

  • Prevention Professional
  • Annapolis, MD
National Provider Identifier
1477078053
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prevention ProfessionalTaxonomy code 405300000X
Legal business name
FMCA PA
Practice address
2562 Hidden Cove Rd
Annapolis, MD 21401-6815
Phone
(540) 529-5472
NPI assigned
Aug 4, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Naiyer Imam, MD
Title
Owner
Phone
(540) 529-5472

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X
Prevention ProfessionalGroup: 193200000X MULTI-SPECIALTY GROUP 405300000X Primary

Addresses

Primary practice location

2562 Hidden Cove Rd
Annapolis, MD 21401-6815

Mailing address

2562 Hidden Cove Rd
Annapolis, MD 21401-6815
Phone (540) 529-5472

National Provider Directory

National Provider Directory

Locations

700 E Township Line Rd
Ste 200
Havertown, PA 19083
Phone (540) 529-5472

NPI Registry JSON

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

{
    "created_epoch": "1501804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1477078053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2562 HIDDEN COVE RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214016815",
            "telephone_number": "540-529-5472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2562 HIDDEN COVE RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214016815",
            "telephone_number": "540-529-5472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMCA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-04",
        "last_updated": "2022-07-21",
        "certification_date": "2020-09-22",
        "status": "A",
        "authorized_official_last_name": "IMAM",
        "authorized_official_first_name": "NAIYER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-529-5472",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Prevention Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.