Basic Information
| Provider Information | |||||||||
| NPI: | 1467426072 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FASIUDDIN | ||||||||
| FirstName: | OROOJ | ||||||||
| MiddleName: | F | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3705 5TH AVE | ||||||||
| Address2: | 4B 422 DESOTO WING | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152132524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126925135 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3705 5TH AVE | ||||||||
| Address2: | 4B 422 DESOTO WING | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152132524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126925135 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2006 | ||||||||
| LastUpdateDate: | 12/11/2015 | ||||||||
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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 | 174400000X | MD426468 | PA | N | Other Service Providers | Specialist | 207P00000X | MD.34407 | AL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 208000000X | MD.34407 | AL | N | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 101299772 | 05 | PA | MEDICAID | 177100 | 05 | AL | MEDICAID | 511-65443 | 01 | AL | BCBS | OTHER | 175248 | 05 | AL | MEDICAID | 511-65436 | 01 | AL | BCBS | OTHER |