Individual
MIRZA M. NUSAIREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1401 MADISON PARK DR, SUITE #100, GLEN BURNIE, MD 21061
(410) 766-4747
(410) 766-4855
Mailing address
1403 MADISON PARK DR, SUITE 300, GLEN BURNIE, MD 21061-6189
(410) 766-4747
(410) 766-4855
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0040519
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079341800
—
MD
Enumeration date
05/31/2006
Last updated
12/06/2022
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