Provider Demographics
NPI:1629470547
Name:HEFUNA MENTAL HEALTH WELLNESS LLC
Entity Type:Organization
Organization Name:HEFUNA MENTAL HEALTH WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:HEFUNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-345-1022
Mailing Address - Street 1:16220 FREDERICK RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-4039
Mailing Address - Country:US
Mailing Address - Phone:301-345-1022
Mailing Address - Fax:301-560-5557
Practice Address - Street 1:16220 FREDERICK RD
Practice Address - Street 2:SUITE 310
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-4039
Practice Address - Country:US
Practice Address - Phone:301-345-1022
Practice Address - Fax:301-560-5557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD665762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD66576OtherMD LICENSE