MEDICARE: MR. BABAK RAZI 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	207RN0300X	Nephrology Physician	CS0111967	DC
2	207RN0300X	Nephrology Physician	D0057039	MD

General Provider Information

NPI Number	:	1942345970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BABAK RAZI MD

Provider Business Mailing Address
First Line	:	4404 QUEENSBURY RD
Second Line	:	SUITE 100
City	:	RIVERDALE
State	:	MD
Zip	:	20737-1068
Country	:	US
Telephone Number	:	301-779-1949
Fax Number	:	301-699-1703

Provider Business Practice Location Address
First Line	:	4404 QUEENSBURY RD
Second Line	:	SUITE 100
City	:	RIVERDALE
State	:	MD
Zip	:	20737-1068
Country	:	US
Telephone Number	:	301-779-1949
Fax Number	:	301-699-1703

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

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	01/31/2013

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