Provider Demographics
NPI:1366483323
Name:MURSHED, FARID (MD)
Entity Type:Individual
Prefix:
First Name:FARID
Middle Name:
Last Name:MURSHED
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 1:1126 OPAL CT
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5940
Mailing Address - Country:US
Mailing Address - Phone:240-420-2666
Mailing Address - Fax:240-420-0951
Practice Address - Street 1:1126 OPAL COURT
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740
Practice Address - Country:US
Practice Address - Phone:240-420-2666
Practice Address - Fax:240-420-0951
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0060396207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4031466DOMedicaid
MD3457555OtherAETNA
MD40346600OtherMDC
MD62188001OtherBSMD
MDP00063415OtherRRMC
H51284Medicare UPIN
MD742M95FMedicare ID - Type UnspecifiedINDIVIDUAL