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General NPI Number Information
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NPI Number | 1962436956
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Entity Type | Organization
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Legal Business Name | DARIOUSH NASSERI MD PA
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 09/20/2011
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Provider Practice Location Address
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Address Line | 5601 LOCH RAVEN BLVD STE G2
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City | BALTIMORE
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State | MD
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Zip | 21239-2905
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Country | US
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Telephone | 410-435-8100
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Fax | 443-444-4830
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Provider Business Mailing Address
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Address Line | 5601 LOCH RAVEN BLVD STE G2
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City | BALTIMORE
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State | MD
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Zip | 21239-2905
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Country | US
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Telephone | 410-435-8100
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Fax | 443-444-4830
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Authorized Official
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Title or Position | ORTHOPAEDIC SURGEON
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Name | DR. DARIOUSH NASSERI
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Credential | MD PA
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Telephone | 410-435-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | D0026027
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License Number State | MD
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