Provider Demographics
NPI:1265619878
Name:BAZZI, MOUHAMAD (MD)
Entity type:Individual
Prefix:
First Name:MOUHAMAD
Middle Name:
Last Name:BAZZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2405 WHITTIER DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-3361
Mailing Address - Country:US
Mailing Address - Phone:301-682-2988
Mailing Address - Fax:301-682-2989
Practice Address - Street 1:2405 WHITTIER DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-3361
Practice Address - Country:US
Practice Address - Phone:301-682-2988
Practice Address - Fax:301-682-2989
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2017-04-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDPP20574207R00000X
MDD0072463207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine