Provider Demographics
NPI:1679931430
Name:MOZAMMEL PALAD, SHEHZIN (MS, CRNA)
Entity type:Individual
Prefix:
First Name:SHEHZIN
Middle Name:
Last Name:MOZAMMEL PALAD
Suffix:
Gender:F
Credentials:MS, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HUNTING HORN CT
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-5300
Mailing Address - Country:US
Mailing Address - Phone:443-538-5211
Mailing Address - Fax:
Practice Address - Street 1:9 HUNTING HORN CT
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-5300
Practice Address - Country:US
Practice Address - Phone:443-538-5211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-08
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR191732163W00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse