Samia Azhar

Individual provider Active NPI General Practice Dentistry · Elkridge, MD

NPI 1720136252 · NPPES record last updated May 7, 2013

Key facts

NPI
1720136252
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
13217 (MD)
Practice address
6020 Meadowridge Center Dr
Elkridge, MD 21075-6088
Phone
(410) 782-3124
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
13217MDMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13217 MD Yes

Addresses

Primary practice location

6020 Meadowridge Center Dr
Elkridge, MD 21075-6088

Mailing address

6020 Meadowridge Center Dr
Elkridge, MD 21075-6088
Phone (410) 782-3124

Other providers in Elkridge, MD

All providers in Elkridge, MD · General Practice Dentistry in Maryland

Sources for this page

Verify at the official NPI Registry.