Provider Demographics
NPI:1740202258
Name:MATERNAL FETAL ASSOCIATES OF THE MID-ATLANTIC
Entity Type:Organization
Organization Name:MATERNAL FETAL ASSOCIATES OF THE MID-ATLANTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MOUSTAFA
Authorized Official - Middle Name:MOHAMMED
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-408-3667
Mailing Address - Street 1:10230 NEW HAMPSHIRE AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1400
Mailing Address - Country:US
Mailing Address - Phone:301-408-3667
Mailing Address - Fax:
Practice Address - Street 1:10230 NEW HAMPSHIRE AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1400
Practice Address - Country:US
Practice Address - Phone:301-408-3667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Multi-Specialty