Provider Demographics
NPI:1962409375
Name:HAQUE, KALEEM U (MD)
Entity type:Individual
Prefix:
First Name:KALEEM
Middle Name:U
Last Name:HAQUE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5601 LOCH RAVEN BLVD
Mailing Address - Street 2:STE 3
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-2905
Mailing Address - Country:US
Mailing Address - Phone:443-444-3775
Mailing Address - Fax:443-444-4678
Practice Address - Street 1:5601 LOCH RAVEN BLVD
Practice Address - Street 2:STE 3
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-2905
Practice Address - Country:US
Practice Address - Phone:443-444-3775
Practice Address - Fax:443-444-4678
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2011-09-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0050282207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD54744803OtherBLUE SHIELD
MD571210600Medicaid
G01470Medicare UPIN