Active NPI
Fmca PA
- Prevention Professional
- Annapolis, MD
National Provider Identifier
1477078053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | |||
| Prevention Professional | 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 DirectoryLocations
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.