Provider Demographics
NPI:1043282783
Name:NAQIB, HADEEL ISSA (MD)
Entity Type:Individual
Prefix:DR
First Name:HADEEL
Middle Name:ISSA
Last Name:NAQIB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 RACE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-2351
Mailing Address - Country:US
Mailing Address - Phone:410-687-6434
Mailing Address - Fax:410-687-9855
Practice Address - Street 1:1232 RACE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-2351
Practice Address - Country:US
Practice Address - Phone:410-687-6434
Practice Address - Fax:410-687-9855
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-06
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0041989208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD760851900Medicaid
MD760851900Medicaid