Provider Demographics
NPI: | 1518946565 |
---|---|
Name: | HANDOO, NUZHAT (MD) |
Entity Type: | Individual |
Prefix: | |
First Name: | NUZHAT |
Middle Name: | |
Last Name: | HANDOO |
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: | 1300 PICCARD DR |
Mailing Address - Street 2: | SUITE 202 |
Mailing Address - City: | ROCKVILLE |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 20850-4303 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 301-921-7900 |
Mailing Address - Fax: | 301-921-7915 |
Practice Address - Street 1: | 200 MEMORIAL AVE |
Practice Address - Street 2: | CARROLL HOSPITAL CENTER |
Practice Address - City: | WESTMINSTER |
Practice Address - State: | MD |
Practice Address - Zip Code: | 21157-5799 |
Practice Address - Country: | US |
Practice Address - Phone: | 410-821-6700 |
Practice Address - Fax: | 410-871-7177 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-01-10 |
Last Update Date: | 2008-10-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MD | D00407034 | 207PP0204X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207PP0204X | Allopathic & Osteopathic Physicians | Emergency Medicine | Pediatric Emergency Medicine |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MD | 763881700 | Medicaid | |
MD | 763881700 | Medicaid | |
MD | 568E910 | Medicare ID - Type Unspecified | |
E62637 | Medicare UPIN | ||
MD | 614E988L | Medicare PIN |