Provider Demographics
NPI:1427143536
Name:MOHSIN ANSARI MD FAAP PC
Entity type:Organization
Organization Name:MOHSIN ANSARI MD FAAP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHSIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANSARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-744-5437
Mailing Address - Street 1:7001 JOHNNYCAKE RD
Mailing Address - Street 2:SUITE # 102
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2418
Mailing Address - Country:US
Mailing Address - Phone:410-744-5437
Mailing Address - Fax:410-744-5436
Practice Address - Street 1:7001 JOHNNYCAKE RD STE 102
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-2419
Practice Address - Country:US
Practice Address - Phone:410-744-5437
Practice Address - Fax:410-744-5436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD407361400Medicaid
MD407361401Medicaid
MDK25I053Medicare ID - Type Unspecified