Provider Demographics
NPI:1720490634
Name:THE NEUROLOGY INSTITUTE FOR BRAIN HEALTH AND FITNESS
Entity type:Organization
Organization Name:THE NEUROLOGY INSTITUTE FOR BRAIN HEALTH AND FITNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MAJID
Authorized Official - Middle Name:
Authorized Official - Last Name:FOTHUI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-200-8106
Mailing Address - Street 1:5550 FRIENDSHIP BLVD
Mailing Address - Street 2:SUITE 450
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-7256
Mailing Address - Country:US
Mailing Address - Phone:301-200-8106
Mailing Address - Fax:410-992-1642
Practice Address - Street 1:5550 FRIENDSHIP BLVD
Practice Address - Street 2:SUITE 450
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-7256
Practice Address - Country:US
Practice Address - Phone:301-200-8106
Practice Address - Fax:410-992-1642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00595072084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty