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NPI Code Detail

MEDICARE: DR. ROSTAM NASSIRI M.D.

MEDICARE: DR. ROSTAM NASSIRI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianD0061989MD

General Provider Information

NPI Number : 1366494288
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROSTAM NASSIRI M.D.
Provider Business Mailing Address
First Line : 13823 OUTLET DR
Second Line :
City : SILVER SPRING
State : MD
Zip : 20904-4971
Country : US
Telephone Number : 301-890-8000
Fax Number : 301-890-1485
Provider Business Practice Location Address
First Line : 13823 OUTLET DR
Second Line :
City : SILVER SPRING
State : MD
Zip : 20904-4971
Country : US
Telephone Number : 301-890-8000
Fax Number : 301-890-1485
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 05/12/2014

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