Provider Demographics
NPI:1720271349
Name:HADEEL NAQIB, M.D., P.A.
Entity Type:Organization
Organization Name:HADEEL NAQIB, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HADEEL
Authorized Official - Middle Name:I
Authorized Official - Last Name:NAQIB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-687-6434
Mailing Address - Street 1:1232 RACE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-2351
Mailing Address - Country:US
Mailing Address - Phone:410-687-6434
Mailing Address - Fax:410-687-9855
Practice Address - Street 1:1232 RACE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-2351
Practice Address - Country:US
Practice Address - Phone:410-687-6434
Practice Address - Fax:410-687-9855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0041989208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD238154OtherMEDICARE
MD760851900Medicaid
MD0N34HIOtherCAREFIRST MARYLAND
DCF185 0001OtherCAREFIRST DC
DCF185 0001OtherCAREFIRST DC