Provider Demographics
NPI:1295719599
Name:DRS. WAHEED ALENCHERRY AND IQBAL PA
Entity type:Organization
Organization Name:DRS. WAHEED ALENCHERRY AND IQBAL PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:
Authorized Official - Last Name:WAHEED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-733-0300
Mailing Address - Street 1:12821 OAK HILL AVE
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-2940
Mailing Address - Country:US
Mailing Address - Phone:301-733-0300
Mailing Address - Fax:301-733-5773
Practice Address - Street 1:12821 OAK HILL AVE
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-2940
Practice Address - Country:US
Practice Address - Phone:301-733-0300
Practice Address - Fax:301-733-5773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-01
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD207RP1001X
207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD403012500Medicaid
MD094LMedicare ID - Type Unspecified
WVDR9337071Medicare PIN