Provider Demographics
NPI:1740593987
Name:HERSI, KADIJA (MD)
Entity Type:Individual
Prefix:
First Name:KADIJA
Middle Name:
Last Name:HERSI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:410-500-4266
Practice Address - Street 1:600 N WOLFE ST BLDG 5TH
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-955-3467
Practice Address - Fax:410-955-0036
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2023-12-18
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Provider Licenses
StateLicense IDTaxonomies
MDD75684207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine