Provider Demographics
NPI:1083009666
Name:SAHBAZ, JASMIN (MD)
Entity Type:Individual
Prefix:
First Name:JASMIN
Middle Name:
Last Name:SAHBAZ
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 1:10710 CHARTER DR STE 400
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3276
Mailing Address - Country:US
Mailing Address - Phone:443-276-9000
Mailing Address - Fax:443-276-9610
Practice Address - Street 1:10710 CHARTER DR STE 400
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3276
Practice Address - Country:US
Practice Address - Phone:443-276-9000
Practice Address - Fax:443-276-9610
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD0090556207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program