Provider Demographics
NPI:1639336738
Name:SYED, MASIUDDIN
Entity Type:Individual
Prefix:MR
First Name:MASIUDDIN
Middle Name:
Last Name:SYED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 BACK RIVER NECK RD
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MD
Mailing Address - Zip Code:21221-3924
Mailing Address - Country:US
Mailing Address - Phone:410-238-0511
Mailing Address - Fax:
Practice Address - Street 1:140 BACK RIVER NECK RD
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MD
Practice Address - Zip Code:21221-3924
Practice Address - Country:US
Practice Address - Phone:410-238-0511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-18
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16927183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist