Healthcare Provider Details

I. General information

NPI: 1477087450
Provider Name (Legal Business Name): MATTHEW ARMAN NAZARI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2017
Last Update Date: 07/20/2021
Certification Date: 06/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

3101 NEW MEXICO AVE NW APT 841
WASHINGTON DC
20016-5908
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-8168
  • Fax:
Mailing address:
  • Phone: 703-927-5133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD049327
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD049327
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: