Provider Demographics
NPI:1538237524
Name:SAMI, SEPPIDEH (RD)
Entity type:Individual
Prefix:MS
First Name:SEPPIDEH
Middle Name:
Last Name:SAMI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25100 HIGHLAND MANOR CT
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20882-3732
Mailing Address - Country:US
Mailing Address - Phone:202-531-8294
Mailing Address - Fax:
Practice Address - Street 1:15225 SHADY GROVE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3254
Practice Address - Country:US
Practice Address - Phone:301-330-0661
Practice Address - Fax:301-977-6940
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD01318133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG00246Medicare ID - Type Unspecified