Provider Demographics
NPI:1942281720
Name:QADIR, GHAZALA NMN (MD)
Entity Type:Individual
Prefix:DR
First Name:GHAZALA
Middle Name:NMN
Last Name:QADIR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1190 MOUNT AETNA RD
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6833
Mailing Address - Country:US
Mailing Address - Phone:301-790-0666
Mailing Address - Fax:301-790-9764
Practice Address - Street 1:1190 MOUNT AETNA RD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6833
Practice Address - Country:US
Practice Address - Phone:301-790-0666
Practice Address - Fax:301-790-9764
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0046561207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G15560Medicare UPIN