Provider Demographics
NPI:1003987629
Name:NAZEMIAN, JAFAR
Entity type:Individual
Prefix:DR
First Name:JAFAR
Middle Name:
Last Name:NAZEMIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6196 OXON HILL RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745
Mailing Address - Country:US
Mailing Address - Phone:301-567-8880
Mailing Address - Fax:301-839-7026
Practice Address - Street 1:6196 OXON HILL RD
Practice Address - Street 2:SUITE 250
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745
Practice Address - Country:US
Practice Address - Phone:301-567-8880
Practice Address - Fax:301-839-7026
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0009162207Q00000X
DCMD25644207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
85352OtherMDIPA OPTIMUM
100232OtherAETNA
DC0720OtherBC
MD6370OtherBC OF MD
DC0001OtherBC
04885OtherAMERIGROUP
365639OtherUNITED HEALTHCARE HMO
MD6370OtherBC OF MD
DC0001OtherBC