Basic Information
| Provider Information | |||||||||
| NPI: | 1053591032 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ASAR | ||||||||
| FirstName: | FIRDOUS | ||||||||
| MiddleName: | H. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10403 HOSPITAL DR | ||||||||
| Address2: | SUITE G4 | ||||||||
| City: | CLINTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207353134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018563019 | ||||||||
| FaxNumber: | 3018569370 | ||||||||
| Practice Location | |||||||||
| Address1: | 10 SAINT PATRICKS DR | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | WALDORF | ||||||||
| State: | MD | ||||||||
| PostalCode: | 206034527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018430222 | ||||||||
| FaxNumber: | 3018430651 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2007 | ||||||||
| LastUpdateDate: | 10/15/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | D0071455 | MD | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | B776 | 01 | DC | BCBS NCA GROUP NUMBER FOR WALDORF FAMILY MEDICAL CENTER | OTHER | 222101211 | 01 | MD | MEDICAID GROUP NUMBER FOR WALDORF FAMILY MEDICAL CENTER | OTHER | KR10 | 01 | MD | MEDICARE GROUP NUMBER FOR WALDORF FAMILY MEDICAL CENTER | OTHER |