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General NPI Number Information
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NPI Number | 1639502313
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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 | 08/16/2013
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 3168 BRAVERTON ST STE 330
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City | EDGEWATER
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State | MD
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Zip | 21037-2680
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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 ST. 200
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City | CATONSVILLE
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State | MD
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Zip | 21228-4147
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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 | OFFICE MANAGER
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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