| Ashraf Fanous, Md Llc | |
|
41625 Park Avenue Suite 300 Leonardtown MD 20650-8252 | |
| (301) 997-1494 | |
| (301) 997-1497 |
| Full Name | Ashraf Fanous, Md Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 41625 Park Avenue, Leonardtown, Maryland |
| Authorized Official Name and Position | Ashraf Fathi Fanous (OWNER) |
| Authorized Official Contact | 3019971494 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ashraf Fanous, Md Llc Po Box 2252 Leonardtown MD 20650-8252 Ph: (301) 997-1494 | Ashraf Fanous, Md Llc 41625 Park Avenue Suite 300 Leonardtown MD 20650-8252 Ph: (301) 997-1494 |
| NPI Number | 1568613701 |
|---|---|
| Provider Enumeration Date | 10/07/2008 |
| Last Update Date | 10/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568613701 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | D0064252 (Maryland) | Primary |
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