Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | D0039328 | MD |
NPI | 1003888488 |
---|---|
Provider Name | Dr. Jamshid Danaie |
First Address | Timonium, MD 21093-3221 |
Second Address | Timonium, MD 21093-3221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 28/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2849 | B/C B/S (01) | DC |
410003400 | (05) | MD |
F16498 | (02) | MD |
J062 | B/C B/S (01) | MD |
KA80 | B/C B/S (01) | MD |