Provider Demographics
NPI:1346304060
Name:BAKIR, MARIAM H (RN, MS, CRNP)
Entity Type:Individual
Prefix:
First Name:MARIAM
Middle Name:H
Last Name:BAKIR
Suffix:
Gender:F
Credentials:RN, MS, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:5730 EXECUTIVE DR STE 230
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1762
Mailing Address - Country:US
Mailing Address - Phone:410-247-5602
Mailing Address - Fax:410-242-1756
Practice Address - Street 1:711 MAIDEN CHOICE LN
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-3632
Practice Address - Country:US
Practice Address - Phone:410-247-5602
Practice Address - Fax:410-242-1756
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR150259363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD12150972Medicaid