Provider Demographics
NPI:1861621211
Name:DARD, SHABIR (MD)
Entity type:Individual
Prefix:
First Name:SHABIR
Middle Name:
Last Name:DARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2415 MUSGROVE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-5202
Mailing Address - Country:US
Mailing Address - Phone:301-989-0193
Mailing Address - Fax:301-879-2325
Practice Address - Street 1:2415 MUSGROVE RD
Practice Address - Street 2:#105
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-5202
Practice Address - Country:US
Practice Address - Phone:301-989-0193
Practice Address - Fax:301-879-2325
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA003727207Q00000X
MDD0075059207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1861621211OtherNPI