Provider Demographics
NPI:1598823221
Name:DR SYED M A RIAZ MD PA
Entity Type:Organization
Organization Name:DR SYED M A RIAZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:MOAZAM ALI
Authorized Official - Last Name:RIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-691-2302
Mailing Address - Street 1:500 S CAMP MEADE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2766
Mailing Address - Country:US
Mailing Address - Phone:410-691-2302
Mailing Address - Fax:410-691-2306
Practice Address - Street 1:500 S CAMP MEADE RD STE B
Practice Address - Street 2:
Practice Address - City:LINTHICUM
Practice Address - State:MD
Practice Address - Zip Code:21090-2703
Practice Address - Country:US
Practice Address - Phone:410-691-2302
Practice Address - Fax:410-691-2306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0040491207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty