Provider Demographics
NPI:1508950627
Name:NAGUIB, ALY MOHAMED FATHY (MD)
Entity Type:Individual
Prefix:
First Name:ALY
Middle Name:MOHAMED FATHY
Last Name:NAGUIB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2 COLGATE DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-2624
Mailing Address - Country:US
Mailing Address - Phone:410-420-0161
Mailing Address - Fax:410-420-0360
Practice Address - Street 1:2 COLGATE DR
Practice Address - Street 2:SUITE 103
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-2624
Practice Address - Country:US
Practice Address - Phone:410-420-0161
Practice Address - Fax:410-420-0360
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2014-03-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0059387207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2128096OtherUNITED HEALTHCARE
5626818OtherFIRST HEALTH
9789691OtherCIGNA
K3100001OtherCAREFIRST BLUE CHOICE
9274758OtherPRIVATE HEALTHCARE SYSTEM
5187209OtherAETNA PPO
P00216824OtherRAILROAD
2953195OtherAETNA HMO
61799202OtherCAREFIRST BLUE CROSS BLUE
8128096OtherOPTIMUM CHOICE
9789691OtherCIGNA
G34333Medicare UPIN