Provider Demographics
NPI:1063529626
Name:HAJJ, MARWAN AHMAD (MD)
Entity type:Individual
Prefix:DR
First Name:MARWAN
Middle Name:AHMAD
Last Name:HAJJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6569 N CHARLES STREET
Mailing Address - Street 2:SUITE 710
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204
Mailing Address - Country:US
Mailing Address - Phone:410-321-1313
Mailing Address - Fax:410-321-1366
Practice Address - Street 1:6569 N CHARLES STREET
Practice Address - Street 2:SUITE 710
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:410-321-1313
Practice Address - Fax:410-321-1366
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0017009207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C49409Medicare UPIN
4078Medicare ID - Type Unspecified