Individual
DR. FARRUKH MAHFUZ JALISI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7845 OAKWOOD RD STE 106, GLEN BURNIE, MD 21061-4256
(410) 760-5100
(410) 760-5932
Mailing address
7845 OAKWOOD RD STE 106, GLEN BURNIE, MD 21061-4256
(410) 760-5100
(410) 760-5932
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20266
WV
207RC0000X
Cardiovascular Disease Physician
0101247118
VA
207RC0000X
Cardiovascular Disease Physician
01065461
IN
207RC0000X
Cardiovascular Disease Physician
20266
WV
207RC0000X
Cardiovascular Disease Physician
241683
NY
207RC0000X
Cardiovascular Disease Physician
D84429
MD
207RI0011X
Interventional Cardiology Physician
0101247118
VA
207RI0011X
Interventional Cardiology Physician
01065461
IN
207RI0011X
Interventional Cardiology Physician
20266
WV
207RI0011X
Interventional Cardiology Physician
241683
NY
207RI0011X
Interventional Cardiology Physician
Primary
D84429
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3091112
—
OH
05
—
3810018590
—
WV
01
—
P00858196
MEDICARE RAILROAD
—
Enumeration date
09/20/2006
Last updated
12/27/2024
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