Healthcare Provider Details

I. General information

NPI: 1740444181
Provider Name (Legal Business Name): MEHRAK MICHAEL MARZBAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2008
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 UNIVERSITY BLVD E STE 11
SILVER SPRING MD
20903-2921
US

IV. Provider business mailing address

831 UNIVERSITY BLVD E STE 11
SILVER SPRING MD
20903-2921
US

V. Phone/Fax

Practice location:
  • Phone: 301-431-0431
  • Fax: 301-431-0470
Mailing address:
  • Phone: 301-431-0431
  • Fax: 301-431-0470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberD0074318
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: