| Organization Name: | EMAD R AL BANNA,M.D.P.A. |
| NPI Number: | 1952626210 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EMAD RASHAD AL BANNA (OWNER) |
| Mailing Address: | 1050 Solomons Island Rd Huntingtown |
| State: | MD US |
| Postal Code: | 20639 |
| Phone Number: | 4105352044 |
| Fax Number: | 4105359324 |
| NPI Enumeration Date: | 03/30/2010 |
| NPI Last Update Date: | 03/30/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | D12705 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |