Provider Demographics
NPI:1518305671
Name:ASLAM, AISHAH (DO)
Entity Type:Individual
Prefix:
First Name:AISHAH
Middle Name:
Last Name:ASLAM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3407 WILKENS AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-5222
Mailing Address - Country:US
Mailing Address - Phone:410-644-5111
Mailing Address - Fax:
Practice Address - Street 1:3407 WILKENS AVE STE 300
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5222
Practice Address - Country:US
Practice Address - Phone:410-644-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-11
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101020678207R00000X
WI71538207RC0000X
MDH99315207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5101020678OtherMEDICAL LICENSE PERMANENT ID
MIA245036019047OtherDRIVERS LICENSE