Provider Demographics
NPI:1841284213
Name:RASUL, AMJAD MIAN (MD)
Entity type:Individual
Prefix:DR
First Name:AMJAD
Middle Name:MIAN
Last Name:RASUL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:17770 CHIPPING CT
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1626
Mailing Address - Country:US
Mailing Address - Phone:301-570-7813
Mailing Address - Fax:202-526-6025
Practice Address - Street 1:1160 VARNUM ST., N.E.
Practice Address - Street 2:#114
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2110
Practice Address - Country:US
Practice Address - Phone:202-526-8966
Practice Address - Fax:202-526-6025
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0025802207RC0000X
DCMD12149207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC024635600Medicaid
25272OtherMAMSI
MD357561600Medicaid
146992001OtherUNITED HEALTH CARE
471514OtherAETNA HMO
3082912OtherCIGNA
521467413OtherMULTIPLAN
DC9476OtherBCBS
110125682OtherMEDICARE RR
1863236OtherFIRST HEALTH PPO
495350OtherNCPPO
4088591OtherAETNA
MD41964107OtherBCBS
495350OtherNCPPO
DC024635600Medicaid