Provider Demographics
NPI:1831370063
Name:MASSOUD, RAYA (MD)
Entity type:Individual
Prefix:
First Name:RAYA
Middle Name:
Last Name:MASSOUD
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 1:8 BANKBARN CIR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21769-7734
Mailing Address - Country:US
Mailing Address - Phone:443-710-6009
Mailing Address - Fax:
Practice Address - Street 1:2405 WHITTIER DR UNIT 100
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-3361
Practice Address - Country:US
Practice Address - Phone:301-799-7588
Practice Address - Fax:301-799-7589
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0080615193400000X
MD224782084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No193400000XGroupSingle Specialty