Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | D0028035 | MD |
N | 111NI0900X | Internist | D0028035 | MD |
Y | 207RC0000X | Internist - Cardiovascular Disease | D0028035 | MD |
NPI | 1003898271 |
---|---|
Provider Name | Basirmohmad F Kolia |
First Address | Brandywine, MD 20613-3047 |
Second Address | Brandywine, MD 20613-3047 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2005 |
Last Update Date | 13/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
060002172 | RAILROAD MEDICARE (01) | MD |
2106083 | AETNA (01) | MD |
39143 | MD-IPA (01) | MD |
4365 | BCBS NCA (01) | DC |
4957 | BCBS MD (01) | MD |
792151900 | (05) | MD |
89143 | MD-IPA (01) | MD |
C61849 | (02) | MD |