Provider Demographics
NPI:1316136013
Name:ASHRAF MOSTAFA MD PA
Entity type:Organization
Organization Name:ASHRAF MOSTAFA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASHRAF MOSTAFA MD PA
Authorized Official - Prefix:DR
Authorized Official - First Name:RASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-404-3081
Mailing Address - Street 1:7505 OSLER DRIVE
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7505 OSLER DRIVE
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:410-821-7572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD131MMedicare PIN