Provider Demographics
NPI:1962620690
Name:NEUROLOGY CONSULTANT, P.A.
Entity type:Organization
Organization Name:NEUROLOGY CONSULTANT, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANWAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-739-5959
Mailing Address - Street 1:235 MILL ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6114
Mailing Address - Country:US
Mailing Address - Phone:301-739-5959
Mailing Address - Fax:301-739-2403
Practice Address - Street 1:235 MILL ST
Practice Address - Street 2:SUITE 1
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6114
Practice Address - Country:US
Practice Address - Phone:301-739-5959
Practice Address - Fax:301-739-2403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0055626174400000X
204R00000X, 261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic MedicineGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD340013100Medicaid
MDM47937Medicare UPIN
MD699267600Medicaid