MEDICARE: FAZEL DINARY 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	208M00000X	Hospitalist Physician	35.127481	OH
2	207RG0100X	Gastroenterology Physician	35.127481	OH

General Provider Information

NPI Number	:	1912347360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FAZEL DINARY M.D

Provider Business Mailing Address
First Line	:	6201 GREENLEIGH AVE
Second Line	:
City	:	MIDDLE RIVER
State	:	MD
Zip	:	21220-2004
Country	:	US
Telephone Number	:	410-933-6423
Fax Number	:

Provider Business Practice Location Address
First Line	:	7700 WASHINGTON VILLAGE DR STE 120
Second Line	:
City	:	CENTERVILLE
State	:	OH
Zip	:	45459-4071
Country	:	US
Telephone Number	:	937-425-4144
Fax Number	:	937-425-4146

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

Provider Enumeration Date	:	06/30/2013
Last Update Date	:	12/04/2025

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Directions to “ FAZEL DINARY M.D” Practice Location

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