Provider Demographics
NPI:1457844342
Name:ASIRI, FERAS AHMED
Entity Type:Individual
Prefix:
First Name:FERAS
Middle Name:AHMED
Last Name:ASIRI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 SOUTH GREENE STREET
Mailing Address - Street 2:ROOM N3E09
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201
Mailing Address - Country:US
Mailing Address - Phone:410-328-6110
Mailing Address - Fax:
Practice Address - Street 1:22 SOUTH GREENE STREET
Practice Address - Street 2:ROOM N3E09
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201
Practice Address - Country:US
Practice Address - Phone:410-328-6110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2019-05-08
Deactivation Date:2019-01-25
Deactivation Code:
Reactivation Date:2019-05-08
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program