Provider Demographics
NPI:1659320257
Name:ABU-GHAIDA, AHMAD M (MD)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:M
Last Name:ABU-GHAIDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10845 PHILADELPHIA RD
Mailing Address - Street 2:
Mailing Address - City:WHITE MARSH
Mailing Address - State:MD
Mailing Address - Zip Code:21162-1717
Mailing Address - Country:US
Mailing Address - Phone:410-335-0008
Mailing Address - Fax:410-335-1133
Practice Address - Street 1:5233 KING AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4001
Practice Address - Country:US
Practice Address - Phone:410-918-1525
Practice Address - Fax:410-918-1526
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD00576132086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD721605000Medicaid
MD61083111OtherCAREFIRST
DC4490 0001OtherCAREFIRST
GAP00335619OtherRAILROAD MEDICARE
G38217Medicare UPIN
DC4490 0001OtherCAREFIRST