MEDICARE: DR. NASSER REZAI MD

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
1	207V00000X	Obstetrics & Gynecology Physician	D10023	MD

General Provider Information

NPI Number	:	1396821203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NASSER REZAI MD

Provider Business Mailing Address
First Line	:	416 GUN ROAD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21227-3823
Country	:	US
Telephone Number	:	410-796-4777
Fax Number	:	410-242-6284

Provider Business Practice Location Address
First Line	:	416 GUN ROAD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21227-3823
Country	:	US
Telephone Number	:	410-796-4777
Fax Number	:	410-242-6284

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. NASSER REZAI MD” Practice Location

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