Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | D0080876 | MD |
NPI | 1396011466 |
---|---|
Provider Name | Dr. Asif Ali Fakhri |
First Address | Cambridge, MD 21613-0800 |
Second Address | Cambridge, MD 21613-3796 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2012 |
Last Update Date | 14/12/2018 |