Healthcare Provider Details

I. General information

NPI: 1497048177
Provider Name (Legal Business Name): SONYA NEDA KAVEH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2011
Last Update Date: 09/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14915 BROSCHART RD SUITE 2200
ROCKVILLE MD
20850-3350
US

IV. Provider business mailing address

14915 BROSCHART RD SUITE 2200
ROCKVILLE MD
20850-3350
US

V. Phone/Fax

Practice location:
  • Phone: 301-838-4912
  • Fax: 301-251-4666
Mailing address:
  • Phone: 301-838-4912
  • Fax: 301-251-4666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number52932
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number81735
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number52932
License Number StateCT
# 4
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number81735
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: