Provider Demographics
NPI:1902127145
Name:BASHIR, JAMIL JAWAID (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMIL
Middle Name:JAWAID
Last Name:BASHIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15204 CANDYTUFT LN
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-1541
Mailing Address - Country:US
Mailing Address - Phone:443-676-0116
Mailing Address - Fax:
Practice Address - Street 1:15204 CANDYTUFT LN
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20853-1541
Practice Address - Country:US
Practice Address - Phone:443-676-0116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME129815208100000X
MDD0089602208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation