Provider Demographics
NPI:1942410022
Name:RASAQ ABU, M.D., P.C.
Entity Type:Organization
Organization Name:RASAQ ABU, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RASAQ
Authorized Official - Middle Name:OLANREWAJU
Authorized Official - Last Name:ABU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-345-8225
Mailing Address - Street 1:PO BOX 692
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-0692
Mailing Address - Country:US
Mailing Address - Phone:301-345-8225
Mailing Address - Fax:301-345-8244
Practice Address - Street 1:6201 GREENBELT RD
Practice Address - Street 2:SUITE M-7
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740-2354
Practice Address - Country:US
Practice Address - Phone:301-345-8225
Practice Address - Fax:301-345-8244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD43772261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty