Provider Demographics
NPI:1164016473
Name:SYED, WAJIDA AMINUDDIN (LAC MAC)
Entity Type:Individual
Prefix:
First Name:WAJIDA
Middle Name:AMINUDDIN
Last Name:SYED
Suffix:
Gender:F
Credentials:LAC MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 CHAPEL RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-1898
Mailing Address - Country:US
Mailing Address - Phone:508-523-3061
Mailing Address - Fax:
Practice Address - Street 1:222 W COLD SPRING LN STE B
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2800
Practice Address - Country:US
Practice Address - Phone:508-523-3061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02786171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist