1699876235 NPI number — NAHID MAZAREI M.D.

Table of content: NAHID MAZAREI M.D. (NPI 1699876235)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699876235 NPI number — NAHID MAZAREI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAZAREI
Provider First Name:
NAHID
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699876235
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/14/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10403 HOSPITAL DR
Provider Second Line Business Mailing Address:
SUITE G4
Provider Business Mailing Address City Name:
CLINTON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20735-3134
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-856-3019
Provider Business Mailing Address Fax Number:
301-856-9370

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
950 E SWAN CREEK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FT WASHINGTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20744-5250
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-203-3345
Provider Business Practice Location Address Fax Number:
301-203-2186
Provider Enumeration Date:
09/26/2006

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: 207V00000X , with the licence number:  D0060499 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1710998968 . This is a "GROUP NPI - FORT WASHINGTON OBGYN SERVICES" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 402278500 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 94298402-K10ME . This is a "BDBS MARYLAND FOR MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: B776-0034 . This is a "BCBS NCA FOR MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1851473722 . This is a "GROUP NPI - MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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