Provider Demographics
NPI:1336657899
Name:JANJUA, KHURRAM (MD)
Entity Type:Individual
Prefix:DR
First Name:KHURRAM
Middle Name:
Last Name:JANJUA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10306 WINSTEAD CT
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:MD
Mailing Address - Zip Code:21163-1310
Mailing Address - Country:US
Mailing Address - Phone:443-570-4603
Mailing Address - Fax:347-588-8845
Practice Address - Street 1:11140 ROCKVILLE PIKE STE 602
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3184
Practice Address - Country:US
Practice Address - Phone:443-570-4603
Practice Address - Fax:347-588-8845
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-18
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD103G00000X
174H00000X, 1744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No174H00000XOther Service ProvidersHealth Educator