Provider Demographics
NPI:1548327919
Name:FUZAYL, ALBERT Y (PA-C)
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:Y
Last Name:FUZAYL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6940 CLEARWIND CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-1638
Mailing Address - Country:US
Mailing Address - Phone:410-205-6525
Mailing Address - Fax:410-602-5303
Practice Address - Street 1:6940 CLEARWIND CT
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-1638
Practice Address - Country:US
Practice Address - Phone:410-205-6525
Practice Address - Fax:410-602-5303
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002158363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical