Healthcare Provider Details

I. General information

NPI: 1457699688
Provider Name (Legal Business Name): NIMA S MOAINIE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2013
Last Update Date: 01/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9801 GEORGIA AVE STE 340
SILVER SPRING MD
20902-5276
US

IV. Provider business mailing address

4201 CONNECTICUT AVE NW SUITE 211
WASHINGTON DC
20008-1158
US

V. Phone/Fax

Practice location:
  • Phone: 202-362-4545
  • Fax:
Mailing address:
  • Phone: 202-362-4545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License NumberD72186
License Number StateMD

VIII. Authorized Official

Name: DR. NIMA S MOAINIE
Title or Position: PRESIDENT
Credential: MD
Phone: 202-362-4545