Individual
DR. KHONDKER M SHAMSUZZOHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
196 THOMAS JOHNSON DR, SUITE # 215, FREDERICK, MD 21702-4397
(301) 668-9988
(301) 668-9977
Mailing address
6567 FORSYTHIA ST, SPRINGFIELD, VA 22150-1167
(703) 822-0845
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D 0057162
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050085552
MEDICARE RAILROAD
—
05
—
754401400
—
MD
Enumeration date
01/15/2007
Last updated
09/27/2012
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