Provider Demographics
NPI:1306917703
Name:MOHAMMAD SARFARAZI, MD, L.L.C.
Entity type:Organization
Organization Name:MOHAMMAD SARFARAZI, MD, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SARFARAZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-365-5809
Mailing Address - Street 1:6011 KIRBY RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-6247
Mailing Address - Country:US
Mailing Address - Phone:301-365-5809
Mailing Address - Fax:301-365-5813
Practice Address - Street 1:7525 GREENWAY CENTER DR STE 309
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770
Practice Address - Country:US
Practice Address - Phone:301-345-4465
Practice Address - Fax:301-345-7797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0048042207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCK165OtherCAREFIRST BCBS GHMSI
MD354BMOtherCAREFIRST OF MARYLAND
DCK165OtherCAREFIRST BCBS GHMSI
MD097000000Medicaid
DCDC8245Medicare PIN
DCG01770Medicare PIN