Provider Demographics
NPI:1447418918
Name:MAROOF, ANISSA MIRZA (MD)
Entity Type:Individual
Prefix:
First Name:ANISSA
Middle Name:MIRZA
Last Name:MAROOF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 MONTGOMERY AVENUE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-0001
Mailing Address - Country:US
Mailing Address - Phone:301-785-7110
Mailing Address - Fax:
Practice Address - Street 1:4300 MONTGOMERY AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4412
Practice Address - Country:US
Practice Address - Phone:301-785-7110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-30
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00709912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry