Provider Demographics
NPI:1891107058
Name:THE NEUROLOGY INSTITUTE FOR BRAIN HEALTH AND FITNESS
Entity Type:Organization
Organization Name:THE NEUROLOGY INSTITUTE FOR BRAIN HEALTH AND FITNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAJID
Authorized Official - Middle Name:
Authorized Official - Last Name:FOTUHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-494-0191
Mailing Address - Street 1:10700 CHARTER DR
Mailing Address - Street 2:210A
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3629
Mailing Address - Country:US
Mailing Address - Phone:443-842-6333
Mailing Address - Fax:410-992-1642
Practice Address - Street 1:10700 CHARTER DR
Practice Address - Street 2:210A
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3629
Practice Address - Country:US
Practice Address - Phone:443-842-6333
Practice Address - Fax:410-992-1642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00595072084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty