Provider Demographics
NPI:1205011640
Name:BOWIE PRIMARY CARE, INC
Entity Type:Organization
Organization Name:BOWIE PRIMARY CARE, INC
Other - Org Name:AZAR M DASHTI MD PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAHRAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-262-2627
Mailing Address - Street 1:4379 NORTHVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716
Mailing Address - Country:US
Mailing Address - Phone:301-262-2627
Mailing Address - Fax:301-262-8411
Practice Address - Street 1:4379 NORTHVIEW DRIVE
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716
Practice Address - Country:US
Practice Address - Phone:301-262-2627
Practice Address - Fax:301-262-8411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty