Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081S0010X | Sports Medicine | 28744 | MD |
N | 213ES0000X | Sports Medicine | 28744 | MD |
Y | 225100000X | Physical Therapist | 28744 | MD |
N | 2251S0007X | Physical Therapist - Sports | 28744 | MD |
N | 2251X0800X | Physical Therapist - Orthopedic | 28744 | MD |
NPI | 1124784236 |
---|---|
Provider Name | Dr. Shahin Hajbarat |
First Address | Rockville, MD 20850-3215 |
Second Address | Silver Spring, MD 20901-1559 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2021 |
Last Update Date | 12/11/2021 |