Provider Demographics
NPI:1710202650
Name:HAQUE, ASIM (MD, PHD)
Entity Type:Individual
Prefix:
First Name:ASIM
Middle Name:
Last Name:HAQUE
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10275 LITTLE PATUXENT PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3445
Mailing Address - Country:US
Mailing Address - Phone:888-464-2466
Mailing Address - Fax:410-740-1518
Practice Address - Street 1:10275 LITTLE PATUXENT PKWY STE 300
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3445
Practice Address - Country:US
Practice Address - Phone:888-464-2466
Practice Address - Fax:410-740-1518
Is Sole Proprietor?:No
Enumeration Date:2010-04-04
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010970872084N0400X
MI537232084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology