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General NPI Number Information
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NPI Number | 1013235894
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Entity Type | Organization
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Legal Business Name | MASSOUD B. ALIZADEH M.D.,PA
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Dates
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Enumeration Date | 05/04/2010
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Last Update Date | 05/04/2010
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Provider Practice Location Address
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Address Line | 240 FREDERICK ST
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City | HAGERSTOWN
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State | MD
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Zip | 21740-6100
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Country | US
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Telephone | 301-739-8049
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Fax | 301-733-3287
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Provider Business Mailing Address
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Address Line | 240 FREDERICK ST
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City | HAGERSTOWN
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State | MD
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Zip | 21740-6100
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Country | US
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Telephone | 301-739-8049
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Fax | 301-733-3287
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MASSOUD B ALIZADEH
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Credential | M.D
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Telephone | 301-739-8049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | D14800
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License Number State | MD
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