Provider Demographics
NPI:1841474970
Name:AMATUN N. NAEEM M.D., P.A.
Entity type:Organization
Organization Name:AMATUN N. NAEEM M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMATUN
Authorized Official - Middle Name:N
Authorized Official - Last Name:NAEEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-528-1100
Mailing Address - Street 1:1800 N.CHARLES STREET,SUIT 408
Mailing Address - Street 2:MCCULLOH HEALTH CENTER
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5909
Mailing Address - Country:US
Mailing Address - Phone:410-528-1100
Mailing Address - Fax:410-528-1102
Practice Address - Street 1:1800 N CHARLES ST STE 408
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-5909
Practice Address - Country:US
Practice Address - Phone:410-699-0990
Practice Address - Fax:410-669-0991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0015503207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD688LMedicare PIN
MDB66690Medicare UPIN