Provider Demographics
NPI:1891954673
Name:MAHMUD, FAIQA (MD)
Entity type:Individual
Prefix:DR
First Name:FAIQA
Middle Name:
Last Name:MAHMUD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FAIQA
Other - Middle Name:
Other - Last Name:NASIR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 37189
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3189
Mailing Address - Country:US
Mailing Address - Phone:571-423-5699
Mailing Address - Fax:571-423-5698
Practice Address - Street 1:46045 PALISADE PKWY
Practice Address - Street 2:
Practice Address - City:POTOMAC FALLS
Practice Address - State:VA
Practice Address - Zip Code:20165-8761
Practice Address - Country:US
Practice Address - Phone:703-430-4343
Practice Address - Fax:571-313-8865
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101257760207QG0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1851473722OtherMEDICAL & SURGICAL CLINICS NPI
DCB776OtherMEDICAL & SURGICAL CLINICS CAREFIRST GROUP - DC
MDKR10MEOtherMEDICAL & SURGICAL CLINICS CAREFIRST GROUP - MARYLAND
DC624316OtherMEDICAL & SURGICAL CLINICS MEDICARE GROUP - DC
MDKR10OtherMEDICAL & SURGICAL CLINICS MEDICARE GROUP - MARYLAND