Provider Demographics
NPI:1275799330
Name:IQBAL, AYESHA (MBBS)
Entity Type:Individual
Prefix:DR
First Name:AYESHA
Middle Name:
Last Name:IQBAL
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4927 LANIER AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5343
Mailing Address - Country:US
Mailing Address - Phone:469-274-7209
Mailing Address - Fax:
Practice Address - Street 1:4927 LANIER AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5343
Practice Address - Country:US
Practice Address - Phone:469-274-7209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP22855208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics