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General NPI Number Information
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NPI Number | 1497188478
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Entity Type | Organization
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Legal Business Name | NASSERI CLINIC OF ARTHRITIC & RHEUMATIC DISEASES LLC
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Dates
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Enumeration Date | 08/14/2013
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 9114 PHILADELPHIA RD STE 208
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City | ROSEDALE
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State | MD
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Zip | 21237-4348
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Country | US
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Telephone | 410-744-0661
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Fax | 410-744-8036
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Provider Business Mailing Address
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Address Line | 700 GEIPE RD STE 200
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City | CATONSVILLE
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State | MD
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Zip | 21228-4176
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Country | US
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Telephone | 410-744-0661
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Fax | 410-744-8036
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | SAMANTHA MIHM
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Credential |
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Telephone | 410-744-0661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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