Provider Demographics
NPI:1699876235
Name:MAZAREI, NAHID (MD)
Entity type:Individual
Prefix:
First Name:NAHID
Middle Name:
Last Name:MAZAREI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10403 HOSPITAL DR
Mailing Address - Street 2:SUITE G4
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-3134
Mailing Address - Country:US
Mailing Address - Phone:301-856-3019
Mailing Address - Fax:301-856-9370
Practice Address - Street 1:950 E SWAN CREEK RD
Practice Address - Street 2:
Practice Address - City:FT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-5250
Practice Address - Country:US
Practice Address - Phone:301-203-3345
Practice Address - Fax:301-203-2186
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0060499207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1710998968OtherGROUP NPI - FORT WASHINGTON OBGYN SERVICES
MD402278500Medicaid
MD94298402-K10MEOtherBDBS MARYLAND FOR MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND
DCB776-0034OtherBCBS NCA FOR MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND
MD1851473722OtherGROUP NPI - MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND
VA015143W97Medicare ID - Type Unspecified
MD402278500Medicaid