Provider Demographics
NPI:1548616931
Name:DARBANDI, MOHAMMAD EHSAN (DO)
Entity type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:EHSAN
Last Name:DARBANDI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 BOULDER CT
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030-2451
Mailing Address - Country:US
Mailing Address - Phone:443-570-5023
Mailing Address - Fax:
Practice Address - Street 1:855 W BRAMBLETON AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1005
Practice Address - Country:US
Practice Address - Phone:757-446-5910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0087081207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine