Provider Demographics
NPI:1346304060
Name:BAKIR, MARIAM H (NP)
Entity type:Individual
Prefix:
First Name:MARIAM
Middle Name:H
Last Name:BAKIR
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:5730 EXECUTIVE DR STE 230
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1762
Mailing Address - Country:US
Mailing Address - Phone:978-536-7850
Mailing Address - Fax:978-536-7851
Practice Address - Street 1:100 BROOKSBY VILLAGE DR
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-1438
Practice Address - Country:US
Practice Address - Phone:978-536-7850
Practice Address - Fax:978-536-7851
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2024-10-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDR150259363LG0600X
MARN10003198363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD12150972Medicaid