Individual
BASIRMOHMAD F KOLIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7704 MATAPEAKE BUSINESS DR STE 325, BRANDYWINE, MD 20613-3047
(301) 373-7900
(301) 373-6900
Mailing address
7704 MATAPEAKE BUSINESS DR STE 325, BRANDYWINE, MD 20613-3047
(301) 373-7900
(301) 373-6900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D0028035
MD
207RC0000X
Cardiovascular Disease Physician
Primary
D0028035
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060002172
RAILROAD MEDICARE
MD
01
—
2106083
AETNA
MD
01
—
39143
MD-IPA
MD
01
—
4365
BCBS NCA
DC
01
—
4957
BCBS MD
MD
05
—
792151900
—
MD
01
—
89143
MD-IPA
MD
Enumeration date
11/15/2005
Last updated
12/13/2021
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