Provider Demographics
NPI:1649439985
Name:RAZAVI, MARYAM AMANDA (MD)
Entity type:Individual
Prefix:DR
First Name:MARYAM
Middle Name:AMANDA
Last Name:RAZAVI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2440 M ST NW
Mailing Address - Street 2:SUITE 409
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1404
Mailing Address - Country:US
Mailing Address - Phone:202-659-2440
Mailing Address - Fax:202-659-1440
Practice Address - Street 1:2440 M ST NW
Practice Address - Street 2:SUITE 409
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1404
Practice Address - Country:US
Practice Address - Phone:202-659-2440
Practice Address - Fax:202-659-1440
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD0354582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry