Provider Demographics
NPI:1972077261
Name:FAMILY UROLOGY ASSOCIATES
Entity Type:Organization
Organization Name:FAMILY UROLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:UROLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:HASEEBUDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-344-8417
Mailing Address - Street 1:184 THOMAS JOHNSON DR STE 201
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4562
Mailing Address - Country:US
Mailing Address - Phone:301-606-0551
Mailing Address - Fax:301-606-1958
Practice Address - Street 1:184 THOMAS JOHNSON DR STE 201
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4562
Practice Address - Country:US
Practice Address - Phone:301-606-0551
Practice Address - Fax:301-606-1958
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY UROLOGY ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-19
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty