Healthcare Provider Details

I. General information

NPI: 1528186285
Provider Name (Legal Business Name): DANIEL ELBOGDADI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 04/27/2022
Certification Date: 04/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14995 SHADY GROVE RD SUITE 250
ROCKVILLE MD
20850-8726
US

IV. Provider business mailing address

2730 UNIVERSITY BLVD W SUITE 310
WHEATON MD
20902-1905
US

V. Phone/Fax

Practice location:
  • Phone: 301-942-7600
  • Fax: 301-217-9241
Mailing address:
  • Phone: 301-942-7600
  • Fax: 301-942-3132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberD0077404
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: