Provider Demographics
NPI:1598740193
Name:AIJAZ, MOHAMMED M
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:M
Last Name:AIJAZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 N ROLLING RD
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-3828
Mailing Address - Country:US
Mailing Address - Phone:410-530-8727
Mailing Address - Fax:
Practice Address - Street 1:1206 N ROLLING RD
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-3828
Practice Address - Country:US
Practice Address - Phone:410-893-5505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-07
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD34077207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDJ784-0001OtherBC/BS
MD069851201Medicaid
MD858MI747Medicare ID - Type Unspecified