Provider Demographics
NPI:1164892733
Name:NAROO, MADIHA YAQOOB
Entity Type:Individual
Prefix:
First Name:MADIHA
Middle Name:YAQOOB
Last Name:NAROO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MADIHA
Other - Middle Name:YAQOOB
Other - Last Name:NAROO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:3625 WESTMOUNT PKWY
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-1881
Mailing Address - Country:US
Mailing Address - Phone:954-707-0098
Mailing Address - Fax:
Practice Address - Street 1:7001 JOHNNYCAKE RD STE 200
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-2420
Practice Address - Country:US
Practice Address - Phone:410-213-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-25
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC07772363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical