Provider Demographics
NPI:1154647402
Name:ASGHAR SHAIGANY, MD LLC
Entity Type:Organization
Organization Name:ASGHAR SHAIGANY, MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ASGHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAIGANY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-864-3888
Mailing Address - Street 1:5632 ANNAPOLIS RD
Mailing Address - Street 2:SUITE 12
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-2213
Mailing Address - Country:US
Mailing Address - Phone:301-864-3888
Mailing Address - Fax:301-699-3007
Practice Address - Street 1:5632 ANNAPOLIS RD
Practice Address - Street 2:SUITE 12
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-2213
Practice Address - Country:US
Practice Address - Phone:301-864-3888
Practice Address - Fax:301-699-3007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-12
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDB94178174400000X
DCMD12938174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD268751800Medicaid