Healthcare Provider Details

I. General information

NPI: 1528193901
Provider Name (Legal Business Name): ASHKAN AAZAMI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 06/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6521 ANNAPOLIS RD
LANDOVER HILLS MD
20784-1311
US

IV. Provider business mailing address

6521 ANNAPOLIS RD
LANDOVER HILLS MD
20784-1311
US

V. Phone/Fax

Practice location:
  • Phone: 301-322-7777
  • Fax: 301-322-5151
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number01701
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: