Individual
MUDUSAR I RAZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12821 OAK HILL AVE, HAGERSTOWN, MD 21742-2940
(301) 733-0300
(301) 733-5773
Mailing address
12821 OAK HILL AVE, HAGERSTOWN, MD 21742-2940
(301) 733-0300
(301) 733-5773
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
053707
GA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
D66166
MD
207RP1001X
Pulmonary Disease Physician
Primary
D66166
MD
207RS0012X
Sleep Medicine (Internal Medicine) Physician
D66166
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
413617900
—
MD
01
—
74960005
CAREFIRST BCBS
DC
01
—
91623801
CAREFIRST BCBS
MD
Enumeration date
08/30/2006
Last updated
04/05/2022
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