Provider Demographics
NPI:1922275098
Name:HAQ, MAHENAAZ (MD)
Entity Type:Individual
Prefix:
First Name:MAHENAAZ
Middle Name:
Last Name:HAQ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5730 EXECUTIVE DR STE 230
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1762
Mailing Address - Country:US
Mailing Address - Phone:410-402-2379
Mailing Address - Fax:410-469-3085
Practice Address - Street 1:8000 FRANKFORD RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-6894
Practice Address - Country:US
Practice Address - Phone:972-232-8080
Practice Address - Fax:800-281-9558
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN0079207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1960692-01Medicaid
TX8BG111OtherBCBS
TX8BG111OtherBCBS