Provider Demographics
NPI:1104235456
Name:A. SHAMS PIRZADEH, M.D., PA
Entity type:Organization
Organization Name:A. SHAMS PIRZADEH, M.D., PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJIV
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-788-2000
Mailing Address - Street 1:716 MAIDEN CHOICE LN
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-5938
Mailing Address - Country:US
Mailing Address - Phone:410-788-2000
Mailing Address - Fax:410-455-9881
Practice Address - Street 1:716 MAIDEN CHOICE LN
Practice Address - Street 2:SUITE 301
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-5938
Practice Address - Country:US
Practice Address - Phone:410-788-2000
Practice Address - Fax:410-455-9881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-11
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0014798174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty