Provider Demographics
NPI:1306828371
Name:MOHIUDDIN, SABIHA M (MD)
Entity Type:Individual
Prefix:MRS
First Name:SABIHA
Middle Name:M
Last Name:MOHIUDDIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:801 TOLL HOUSE AVE
Mailing Address - Street 2:BLDG B SUITE 1
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4564
Mailing Address - Country:US
Mailing Address - Phone:301-694-4760
Mailing Address - Fax:301-694-3373
Practice Address - Street 1:801 TOLL HOUSE AVE
Practice Address - Street 2:BLDG B SUITE 1
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4564
Practice Address - Country:US
Practice Address - Phone:301-694-4760
Practice Address - Fax:301-694-3373
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD39458207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G19520Medicare UPIN
MD232QMedicare ID - Type Unspecified