Provider Demographics
NPI:1972939429
Name:KAMRAN, SYED N (MA MS MS)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:N
Last Name:KAMRAN
Suffix:
Gender:M
Credentials:MA MS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SAINT THOMAS LN
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3803
Mailing Address - Country:US
Mailing Address - Phone:240-672-1464
Mailing Address - Fax:
Practice Address - Street 1:1501 S.CLINTON ST.
Practice Address - Street 2:MAILSTOP CT 05-13
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224
Practice Address - Country:US
Practice Address - Phone:410-953-1830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5849101YA0400X
MDLC 5438101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD07336280Medicaid