Provider Demographics
NPI:1396062915
Name:AMJAD M. RASUL, M.D., P.A.
Entity type:Organization
Organization Name:AMJAD M. RASUL, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMJAD
Authorized Official - Middle Name:MIAN
Authorized Official - Last Name:RASUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-526-8966
Mailing Address - Street 1:1160 VARNUM ST NE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2107
Mailing Address - Country:US
Mailing Address - Phone:202-526-8966
Mailing Address - Fax:202-526-6025
Practice Address - Street 1:1160 VARNUM ST NE
Practice Address - Street 2:SUITE 114
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2107
Practice Address - Country:US
Practice Address - Phone:202-526-8966
Practice Address - Fax:202-526-6025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4088591OtherAETNA USHC
MD471514OtherAETNA HMO/PPO
MD41964101OtherBCBS NATIONAL ACCT.
DC94760001OtherBCBS DC
DC024635600Medicaid
MD25272OtherMDIPA/OPTIMUM CHOICE
MD76900001OtherBCBS MARYLAND
MD3082912OtherCIGNA PPO
MD1863236OtherCOVENTRY/FIRST HEALTH
MD2106613OtherAETNA HMO/PPO
MD110125682OtherMEDICARE RR
MD357561600Medicaid
MD495350OtherNCPPO
MD1863236OtherCOVENTRY/FIRST HEALTH
MD25272OtherMDIPA/OPTIMUM CHOICE