Provider Demographics
NPI:1861460305
Name:MUJAHID, HUMERA P (MD)
Entity Type:Individual
Prefix:DR
First Name:HUMERA
Middle Name:P
Last Name:MUJAHID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HUMERA
Other - Middle Name:P
Other - Last Name:MUJAHID
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6130 LANDOVER RD
Mailing Address - Street 2:
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1022
Mailing Address - Country:US
Mailing Address - Phone:301-322-7737
Mailing Address - Fax:301-386-2794
Practice Address - Street 1:6130 LANDOVER RD
Practice Address - Street 2:
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1022
Practice Address - Country:US
Practice Address - Phone:301-322-7737
Practice Address - Fax:301-386-2794
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0059556207R00000X, 207RP1001X
MDDOO59556207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKQ58K726Medicare PIN
MDH84087Medicare UPIN
MD020718R68Medicare PIN