Provider Demographics
NPI:1457330466
Name:AKHTER, MAHBUBA (MD)
Entity Type:Individual
Prefix:
First Name:MAHBUBA
Middle Name:
Last Name:AKHTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 AURORA ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-1903
Mailing Address - Country:US
Mailing Address - Phone:410-228-4902
Mailing Address - Fax:410-228-3009
Practice Address - Street 1:503 BYRN ST STE 2
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-1917
Practice Address - Country:US
Practice Address - Phone:410-221-7770
Practice Address - Fax:410-221-7863
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD63359207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD64721703OtherBS
MD408961800Medicaid
MDP00353286OtherPALMETTO GBA/RAILROAD MEDICARE
7568688OtherAETNA
E6360011OtherBS DC
E6360011OtherBS DC
MD408961800Medicaid