Provider Demographics
NPI:1194864587
Name:MURAD, LINA (MD)
Entity Type:Individual
Prefix:DR
First Name:LINA
Middle Name:
Last Name:MURAD
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:PO BOX 37111
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3111
Mailing Address - Country:US
Mailing Address - Phone:301-277-1545
Mailing Address - Fax:301-277-1544
Practice Address - Street 1:4155 BLADENSBURG ROAD
Practice Address - Street 2:
Practice Address - City:COLMAR MANOR
Practice Address - State:MD
Practice Address - Zip Code:20722-1928
Practice Address - Country:US
Practice Address - Phone:301-277-1545
Practice Address - Fax:301-277-1544
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0040421174400000X
MDD-0040421207RN0300X
DCMD036318207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
G24026Medicare UPIN