Provider Demographics
NPI:1609814672
Name:SYED, SUFIA (MD)
Entity type:Individual
Prefix:
First Name:SUFIA
Middle Name:
Last Name:SYED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13900 BALTIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5009
Mailing Address - Country:US
Mailing Address - Phone:301-725-5652
Mailing Address - Fax:301-483-3732
Practice Address - Street 1:13900 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707
Practice Address - Country:US
Practice Address - Phone:301-725-5652
Practice Address - Fax:301-483-3723
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0061958207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDI27576Medicare UPIN
MD016558R52Medicare ID - Type Unspecified