Provider Demographics
NPI:1215988217
Name:NAYFEH, TARIQ ALI (MD)
Entity type:Individual
Prefix:DR
First Name:TARIQ
Middle Name:ALI
Last Name:NAYFEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9420 KEY WEST AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6327
Mailing Address - Country:US
Mailing Address - Phone:301-589-3324
Mailing Address - Fax:301-762-6542
Practice Address - Street 1:9420 KEY WEST AVE STE 400
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6327
Practice Address - Country:US
Practice Address - Phone:301-589-3324
Practice Address - Fax:301-762-6542
Is Sole Proprietor?:No
Enumeration Date:2006-05-14
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD63617207XS0114X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD409470100Medicaid
MDH85122Medicare UPIN
MDN164Medicare ID - Type UnspecifiedINDIVIDUAL
MDKR59JHMedicare ID - Type UnspecifiedGROUP