MEDICARE: DR. FARHAD JAMALI 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
1	207R00000X	Internal Medicine Physician	D0058213	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548248388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FARHAD JAMALI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 569
Second Line	:
City	:	GREENBELT
State	:	MD
Zip	:	20768-0569
Country	:	US
Telephone Number	:	301-805-0006
Fax Number	:	301-805-5757

Provider Business Practice Location Address
First Line	:	12150 ANNAPOLIS RD
Second Line	:	SUITE 308
City	:	GLENN DALE
State	:	MD
Zip	:	20769-9183
Country	:	US
Telephone Number	:	301-805-0006
Fax Number	:	301-805-5757

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

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	02/24/2011

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