Provider Demographics
NPI:1346316098
Name:HORMOZI, DARAB (MD)
Entity type:Individual
Prefix:DR
First Name:DARAB
Middle Name:
Last Name:HORMOZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8415 BELLONA LN
Mailing Address - Street 2:SUITE 212
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2055
Mailing Address - Country:US
Mailing Address - Phone:410-825-4022
Mailing Address - Fax:410-825-6439
Practice Address - Street 1:8415 BELLONA LN
Practice Address - Street 2:SUITE 212
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2055
Practice Address - Country:US
Practice Address - Phone:410-825-4022
Practice Address - Fax:410-825-6439
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0035686207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE91304Medicare UPIN
MD151L003BMedicare PIN