MEDICARE: NIMA HASSAN CALAF M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	D0058976	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00312949	OTHER	DC	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	J443-0013	OTHER	DC	CAREFIRST BLUE SHIELD

General Provider Information

NPI Number	:	1790714681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIMA HASSAN CALAF M.D.

Provider Business Mailing Address
First Line	:	4467 OLD BRANCH AVE
Second Line	:	STE 203
City	:	TEMPLE HILLS
State	:	MD
Zip	:	20748-1854
Country	:	US
Telephone Number	:	301-899-1212
Fax Number	:	301-899-3716

Provider Business Practice Location Address
First Line	:	4467 OLD BRANCH AVE
Second Line	:	STE 203
City	:	TEMPLE HILLS
State	:	MD
Zip	:	20748-1854
Country	:	US
Telephone Number	:	301-899-1212
Fax Number	:	301-899-3716

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	07/18/2019

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Directions to “ NIMA HASSAN CALAF M.D.” Practice Location

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