Provider Demographics
NPI:1063450492
Name:TEIMOURIAN, BAHMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BAHMAN
Middle Name:
Last Name:TEIMOURIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5402 MCKINLEY ST
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-3764
Mailing Address - Country:US
Mailing Address - Phone:301-897-5666
Mailing Address - Fax:301-897-3385
Practice Address - Street 1:5402 MCKINLEY ST
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-3764
Practice Address - Country:US
Practice Address - Phone:301-897-5666
Practice Address - Fax:301-897-3385
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0011144174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD052832Medicare ID - Type Unspecified
MDB92986Medicare UPIN