Organization
WHITE SQUARE VASCULAR SURGERY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AHMAD ABU-GHAIDA M.D. (PRESIDENT)
(410) 918-1525
Entity
Organization
Contact information
Practice address
5233 KING AVE, SUITE 208, BALTIMORE, MD 21237-4003
(410) 918-1525
(410) 918-1526
Mailing address
10845 PHILADELPHIA RD, WHITE MARSH, MD 21162-1717
(410) 335-0008
(410) 335-3113
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09QSAM
CAREFIRST MD
MD
01
—
4490
CAREFIRST DC
DC
01
—
462105100
MEDICAL ASSISTANCE
MD
01
—
DF0610
RAILROAD MEDICARE
GA
Enumeration date
07/06/2006
Last updated
01/21/2022
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