Provider Demographics
NPI:1427178383
Name:MEDICAL DIAGNOSTIC ASSOCIATES
Entity type:Organization
Organization Name:MEDICAL DIAGNOSTIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FARZIN
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:301-983-5787
Mailing Address - Street 1:PO BOX 61443
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20859-1443
Mailing Address - Country:US
Mailing Address - Phone:301-983-5787
Mailing Address - Fax:301-983-3935
Practice Address - Street 1:10600 RIVER OAKS LN
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-1353
Practice Address - Country:US
Practice Address - Phone:301-983-5787
Practice Address - Fax:301-983-3935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD24061207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty