Provider Demographics
NPI:1790857688
Name:SHAKIL, HUMA (MD)
Entity Type:Individual
Prefix:DR
First Name:HUMA
Middle Name:
Last Name:SHAKIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HUMA
Other - Middle Name:
Other - Last Name:SHAKIL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:625 KENT AVE
Mailing Address - Street 2:SUITE #204
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-3794
Mailing Address - Country:US
Mailing Address - Phone:301-777-7300
Mailing Address - Fax:301-723-4000
Practice Address - Street 1:625 KENT AVE
Practice Address - Street 2:SUITE #204
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-3794
Practice Address - Country:US
Practice Address - Phone:301-777-7300
Practice Address - Fax:301-723-4000
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD463646207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD149631000Medicaid
MD260581710OtherMISC INS
MD260581710OtherCOMM INS
MD53295002OtherBCBS-NEW
MDM6720001OtherBCBS-FED & BLUE CHOICE
MD236826OtherALLIANCE
MDP11632OtherBCBS POS
MDP18192OtherBCBS POS-NEW
MD836826OtherMDIPA
MD53295001OtherBCBS
MDR9110001OtherFEDERAL BCBS & BLUE CHOICE
MD53295001OtherBCBS
MD836826OtherMDIPA
MDP11632OtherBCBS POS