Organization
JAMALODEEN BAKSH MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMALODEEN BAKSH MD (CEO)
(301) 942-0991
Entity
Organization
Contact information
Practice address
3951 FERRARA DR, CONNECTICUT BELAIR MEDICAL PARK, SILVER SPRING, MD 20906-4709
(301) 942-0991
(301) 942-0682
Mailing address
3951 FERRARA DR, CONNECTICUT BELAIR MEDICAL PARK, SILVER SPRING, MD 20906-4709
(301) 942-0991
(301) 942-0682
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
D0023050
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
787201100
—
MD
01
—
P713-0001
BC/BS
DC
Enumeration date
05/10/2010
Last updated
05/10/2010
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