Provider Demographics
NPI:1700882255
Name:MERAJ, SHAFQUAT (MD)
Entity type:Individual
Prefix:DR
First Name:SHAFQUAT
Middle Name:
Last Name:MERAJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1015 PRINCE FREDERICK BLVD
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-3193
Mailing Address - Country:US
Mailing Address - Phone:013-373-7900
Mailing Address - Fax:301-373-6900
Practice Address - Street 1:10 SAINT PATRICKS DR
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4527
Practice Address - Country:US
Practice Address - Phone:301-373-7900
Practice Address - Fax:301-373-6900
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0060084208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD402838400Medicaid
MD402838400Medicaid
MDH84812Medicare UPIN