Provider Demographics
NPI:1578010617
Name:INFECTIOUS DISEASE ASSOCIATES LLC
Entity Type:Organization
Organization Name:INFECTIOUS DISEASE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FAHEEM
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-414-0931
Mailing Address - Street 1:9038 SUNNI SHADE CT
Mailing Address - Street 2:
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-9222
Mailing Address - Country:US
Mailing Address - Phone:443-414-0931
Mailing Address - Fax:443-643-1545
Practice Address - Street 1:615 W MACPHAIL RD STE 206
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4305
Practice Address - Country:US
Practice Address - Phone:443-643-2236
Practice Address - Fax:443-643-1545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD56942261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty