Provider Demographics
NPI:1902895063
Name:BEHRAM, NANCY G (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:G
Last Name:BEHRAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14995 SHADY GROVE RD STE 410
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-8726
Mailing Address - Country:US
Mailing Address - Phone:301-294-8525
Mailing Address - Fax:301-294-5919
Practice Address - Street 1:14995 SHADY GROVE RD STE 410
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-8726
Practice Address - Country:US
Practice Address - Phone:301-294-8525
Practice Address - Fax:301-294-5919
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0056168207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0056168OtherMEDICAL LICENSE
MDH21186Medicare UPIN
MDD0056168OtherMEDICAL LICENSE