Basic Information
Provider Information
NPI: 1225201916
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JAMSHIDI
FirstName: TAHEREH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2041 GEORGIA AVE NW TOWER 2301
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200600001
CountryCode: US
TelephoneNumber: 2028653290
FaxNumber: 2028651888
Practice Location
Address1: 2041 GEORGIA AVE NW TOWER 2301
Address2:  
City: WASHINGTON
State: DC
PostalCode: 20060
CountryCode: US
TelephoneNumber: 2028653290
FaxNumber: 2028651888
Other Information
ProviderEnumerationDate: 04/02/2008
LastUpdateDate: 11/08/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RR0500XMD040084DCY Allopathic & Osteopathic PhysiciansInternal MedicineRheumatology

No ID Information.


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