Provider Demographics
NPI:1033121843
Name:MIR, RUQAYYA (MD)
Entity Type:Individual
Prefix:DR
First Name:RUQAYYA
Middle Name:
Last Name:MIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6 HOUNDSTOOTH CT
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1503
Mailing Address - Country:US
Mailing Address - Phone:410-687-9969
Mailing Address - Fax:410-687-6696
Practice Address - Street 1:9106 PHILADELPHIA RD
Practice Address - Street 2:204
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4329
Practice Address - Country:US
Practice Address - Phone:410-687-9969
Practice Address - Fax:410-687-6696
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0026155208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics