Provider Demographics
NPI:1922323377
Name:ZAFAR A. ANSARI MD PA
Entity Type:Organization
Organization Name:ZAFAR A. ANSARI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:ZAFAR
Authorized Official - Middle Name:ABULHASAN
Authorized Official - Last Name:ANSARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-396-4800
Mailing Address - Street 1:7 POST OFFICE RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-2744
Mailing Address - Country:US
Mailing Address - Phone:301-396-4800
Mailing Address - Fax:301-396-4802
Practice Address - Street 1:7 POST OFFICE RD
Practice Address - Street 2:SUITE E
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-2744
Practice Address - Country:US
Practice Address - Phone:301-396-4800
Practice Address - Fax:301-396-4802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0053219174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD7302029Medicaid
VA005867983Medicaid
DC490114Medicare PIN
G73518Medicare UPIN
VA005867983Medicaid