1275549081 NPI number — DR. SEPIDEH NASSABEH MD

Table of content: DR. SEPIDEH NASSABEH MD (NPI 1275549081)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275549081 NPI number — DR. SEPIDEH NASSABEH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NASSABEH
Provider First Name:
SEPIDEH
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MONTAZAMI
Provider Other First Name:
SEPIDEH
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1275549081
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/08/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3001 HOSPITAL DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHEVERLY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20785
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-618-2000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3001 HOSPITAL DRIVE
Provider Second Line Business Practice Location Address:
NEONATAL INTENSIVE CARE UNIT, PRINCE GEORGES HOSPITAL
Provider Business Practice Location Address City Name:
CHEVERLY
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20785
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-618-2000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/01/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2080N0001X , with the licence number:  MD035279 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)