NPIMap

Organization Active NPI

Ashraf Fanous, MD LLC

  • Psychiatry Physician
  • Leonardtown, MD
National Provider Identifier
1568613701
Registry record updated Oct 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D0064252 Issued in MD
Legal business name
ASHRAF FANOUS, MD LLC
Practice address
41625 Park Avenue
Suite 300
Leonardtown, MD 20650-8252
Phone
(301) 997-1494
Fax
(301) 997-1497
NPI assigned
Oct 7, 2008
Last updated
Oct 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2008

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

Authorized official

Name
Ashraf Fathi Fanous, M.D.
Title
Owner
Phone
(301) 997-1494

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X D0064252 MD Primary

Addresses

Primary practice location

41625 Park Avenue
Suite 300
Leonardtown, MD 20650-8252

Mailing address

PO Box 2252
Leonardtown, MD 20650-8252
Phone (301) 997-1494

National Provider Directory

National Provider Directory

Locations

41625 Park Ave
Ste 300
Leonardtown, MD 20650
Phone (301) 475-3208

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223337600000",
    "number": "1568613701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2252",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206508252",
            "telephone_number": "301-997-1494",
            "fax_number": "301-997-1497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41625 PARK AVENUE",
            "address_2": "SUITE 300",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206508252",
            "telephone_number": "301-997-1494",
            "fax_number": "301-997-1497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHRAF FANOUS, MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-10-07",
        "status": "A",
        "authorized_official_last_name": "FANOUS",
        "authorized_official_first_name": "ASHRAF",
        "authorized_official_middle_name": "FATHI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-997-1494",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0064252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leonardtown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; 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.