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General NPI Number Information
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NPI Number | 1568667996
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Entity Type | Organization
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Legal Business Name | ABBAS MOTAZEDI, MD
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Dates
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Enumeration Date | 06/16/2007
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 1160 VARNUM ST NE STE 111
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City | WASHINGTON
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State | DC
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Zip | 20017-2110
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Country | US
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Telephone | 202-269-0381
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Fax | 202-269-0390
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Provider Business Mailing Address
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Address Line | PO BOX 1410
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City | GREAT FALLS
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State | VA
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Zip | 22066-8410
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ABBAS MOTAZEDI
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Credential | M.D.
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Telephone | 202-269-0381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MD11580
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License Number State | DC
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