Provider Demographics
NPI:1407032485
Name:MAJOR, MARK AMMAAN (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:AMMAAN
Last Name:MAJOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2129 CLARK PL
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1175
Mailing Address - Country:US
Mailing Address - Phone:301-585-1833
Mailing Address - Fax:240-235-3898
Practice Address - Street 1:1300 SPRING STREET
Practice Address - Street 2:SUITE 122
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910
Practice Address - Country:US
Practice Address - Phone:301-585-1833
Practice Address - Fax:240-235-3898
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-21
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD036021207Q00000X
MD261QU0200X
MDD0064592207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCP00847869OtherRAILROAD MEDICARE
VA1407032485Medicaid
MD7578010001OtherMEDICARE PTAN
MD0328090 00Medicaid
DC165615ZBDDMedicare PIN
MD154793Y1ZMedicare PIN
VAVAA100550Medicare PIN