Provider Demographics
NPI:1487690459
Name:BABAN, OTHMAN AHMAD (MD)
Entity type:Individual
Prefix:DR
First Name:OTHMAN
Middle Name:AHMAD
Last Name:BABAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6228 OXON HILL RD
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745
Mailing Address - Country:US
Mailing Address - Phone:301-839-0770
Mailing Address - Fax:301-839-1350
Practice Address - Street 1:6228 OXON HILL RD
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745
Practice Address - Country:US
Practice Address - Phone:301-839-0770
Practice Address - Fax:301-839-1350
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0014590208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC09460001OtherCAREFIRST
MD41048001OtherCAREFIRST
DC09460001OtherCAREFIRST
MDB93824Medicare UPIN