Provider Demographics
NPI:1912954314
Name:METRO INFECTIOUS DISEASE CONSULTANTS ,PC
Entity Type:Organization
Organization Name:METRO INFECTIOUS DISEASE CONSULTANTS ,PC
Other - Org Name:METRO INFECTIOUS DISEASE CONSULTANTS ,PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMEH
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-605-7468
Mailing Address - Street 1:10110 MOLECULAR DRIVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850
Mailing Address - Country:US
Mailing Address - Phone:301-605-7468
Mailing Address - Fax:301-605-7469
Practice Address - Street 1:10110 MOLECULAR DRIVE
Practice Address - Street 2:SUITE 105
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850
Practice Address - Country:US
Practice Address - Phone:301-605-7468
Practice Address - Fax:301-605-7469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2019-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD419315600Medicaid
DCG01943Medicare UPIN