Provider Demographics
NPI:1104925122
Name:FEROZ A PADDER
Entity type:Organization
Organization Name:FEROZ A PADDER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FEROZ
Authorized Official - Middle Name:AHMAD
Authorized Official - Last Name:PADDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-456-4772
Mailing Address - Street 1:7350 VAN DUSEN RD
Mailing Address - Street 2:SUITE B 40
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5263
Mailing Address - Country:US
Mailing Address - Phone:240-456-4772
Mailing Address - Fax:240-456-4774
Practice Address - Street 1:7350 VAN DUSEN RD
Practice Address - Street 2:SUITE B 40
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5263
Practice Address - Country:US
Practice Address - Phone:240-456-4772
Practice Address - Fax:240-456-4774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD310602100Medicaid
MD409780700Medicaid
MD409975300Medicaid
MD25765110Medicaid
MD310602100Medicaid
MD25765110Medicaid
MDG16277Medicare UPIN
MDI35332Medicare UPIN
MDE80623Medicare UPIN
MD225NM740Medicare ID - Type Unspecified
MD409780700Medicaid
MDG42857Medicare UPIN