Provider Demographics
NPI:1033658802
Name:ALIREZA S NEJAD, MD, PHD LLC
Entity Type:Organization
Organization Name:ALIREZA S NEJAD, MD, PHD LLC
Other - Org Name:ALLERGY IMMUNOLOGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALIREZA
Authorized Official - Middle Name:SADEGH
Authorized Official - Last Name:NEJAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:410-937-4444
Mailing Address - Street 1:54 SCOTT ADAM RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030-3216
Mailing Address - Country:US
Mailing Address - Phone:410-937-4444
Mailing Address - Fax:410-343-7862
Practice Address - Street 1:54 SCOTT ADAM RD
Practice Address - Street 2:SUITE 106
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-3216
Practice Address - Country:US
Practice Address - Phone:410-937-4444
Practice Address - Fax:410-343-7862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0075718207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty