Basic Information
| Provider Information | |||||||||
| NPI: | 1699876235 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAZAREI | ||||||||
| FirstName: | NAHID | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10403 HOSPITAL DR | ||||||||
| Address2: | SUITE G4 | ||||||||
| City: | CLINTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207353134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018563019 | ||||||||
| FaxNumber: | 3018569370 | ||||||||
| Practice Location | |||||||||
| Address1: | 950 E SWAN CREEK RD | ||||||||
| Address2: | |||||||||
| City: | FT WASHINGTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207445250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3012033345 | ||||||||
| FaxNumber: | 3012032186 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2006 | ||||||||
| LastUpdateDate: | 05/14/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | D0060499 | MD | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 1710998968 | 01 | MD | GROUP NPI - FORT WASHINGTON OBGYN SERVICES | OTHER | 402278500 | 05 | MD | MEDICAID | 94298402-K10ME | 01 | MD | BDBS MARYLAND FOR MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND | OTHER | B776-0034 | 01 | DC | BCBS NCA FOR MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND | OTHER | 1851473722 | 01 | MD | GROUP NPI - MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND | OTHER |