Provider Demographics
NPI:1154717783
Name:LISKE-DOORANDISH, DARIUSH II (MD)
Entity type:Individual
Prefix:DR
First Name:DARIUSH
Middle Name:
Last Name:LISKE-DOORANDISH
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:DARIUSH
Other - Middle Name:
Other - Last Name:DOORANDISH
Other - Suffix:II
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1332 WATERBURY RD
Mailing Address - Street 2:
Mailing Address - City:CROWNSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21032-1410
Mailing Address - Country:US
Mailing Address - Phone:540-392-4564
Mailing Address - Fax:
Practice Address - Street 1:1332 WATERBURY RD
Practice Address - Street 2:
Practice Address - City:CROWNSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21032-1410
Practice Address - Country:US
Practice Address - Phone:540-392-4564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-10
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0085923207R00000X
MDD85923207R00000X
SCMMD84105207RN0300X
FLME157596207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology