MEDICARE: SHABIR DARD 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	207Q00000X	Family Medicine Physician	003727	GA
2	207Q00000X	Family Medicine Physician	D0075059	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1861621211	OTHER	MD	NPI

General Provider Information

NPI Number	:	1861621211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHABIR DARD M.D.

Provider Business Mailing Address
First Line	:	2415 MUSGROVE RD
Second Line	:	SUITE 105
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-5202
Country	:	US
Telephone Number	:	301-989-0193
Fax Number	:	301-879-2325

Provider Business Practice Location Address
First Line	:	2415 MUSGROVE RD
Second Line	:	#105
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-5202
Country	:	US
Telephone Number	:	301-989-0193
Fax Number	:	301-879-2325

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

Provider Enumeration Date	:	07/07/2009
Last Update Date	:	01/31/2013

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