Provider Demographics
NPI:1497191811
Name:XENON HEALTH OF MARYLAND LLC
Entity Type:Organization
Organization Name:XENON HEALTH OF MARYLAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-621-6854
Mailing Address - Street 1:8560 W SUNSET BLVD
Mailing Address - Street 2:SUITE 511
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-2311
Mailing Address - Country:US
Mailing Address - Phone:917-621-6854
Mailing Address - Fax:646-304-1681
Practice Address - Street 1:66 PAINTERS MILL RD
Practice Address - Street 2:#106
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3641
Practice Address - Country:US
Practice Address - Phone:443-394-0520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211953207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty