Provider Demographics
NPI:1770768483
Name:SAJJAD AZIZ, M.D., P.A.
Entity type:Organization
Organization Name:SAJJAD AZIZ, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SAJJAD
Authorized Official - Middle Name:AHMAD
Authorized Official - Last Name:AZIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-663-1566
Mailing Address - Street 1:801 TOLL HOUSE AVE STE C3
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4555
Mailing Address - Country:US
Mailing Address - Phone:301-662-1566
Mailing Address - Fax:
Practice Address - Street 1:801 TOLL HOUSE AVE STE C3
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4555
Practice Address - Country:US
Practice Address - Phone:301-662-1566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0058391207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH25427Medicare UPIN
506MMedicare PIN