Provider Demographics
NPI:1255586509
Name:AFZAL, MELINDA (DO)
Entity type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:
Last Name:AFZAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9910 FRANKLIN SQUARE DR # 2110
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4902
Mailing Address - Country:US
Mailing Address - Phone:410-933-5412
Mailing Address - Fax:410-933-1390
Practice Address - Street 1:2003 MEDICAL PKWY
Practice Address - Street 2:SUITE 150
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401
Practice Address - Country:US
Practice Address - Phone:443-481-1199
Practice Address - Fax:443-481-1495
Is Sole Proprietor?:No
Enumeration Date:2008-11-28
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH76054207Q00000X, 207V00000X
PAOT012625207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD067495800Medicaid
MD067495800Medicaid
MD297134YBL9Medicare PIN