Provider Demographics
NPI:1912166430
Name:ADVANCED NEUROLOGY AND SLEEP CENTER OF FREDERICK
Entity Type:Organization
Organization Name:ADVANCED NEUROLOGY AND SLEEP CENTER OF FREDERICK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SALAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUGHAYER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:301-367-9771
Mailing Address - Street 1:174 THOMAS JOHNSON DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4423
Mailing Address - Country:US
Mailing Address - Phone:301-668-9380
Mailing Address - Fax:301-668-9480
Practice Address - Street 1:174 THOMAS JOHNSON DR
Practice Address - Street 2:SUITE 100
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4423
Practice Address - Country:US
Practice Address - Phone:301-668-9380
Practice Address - Fax:301-668-9480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH00657002084N0400X, 2084N0600X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Single Specialty