Provider Demographics
NPI:1205031606
Name:BAZZAZIEH, NAVA (DC)
Entity Type:Individual
Prefix:
First Name:NAVA
Middle Name:
Last Name:BAZZAZIEH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 LAUREL BOWIE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-4000
Mailing Address - Country:US
Mailing Address - Phone:410-715-4833
Mailing Address - Fax:301-352-0893
Practice Address - Street 1:6000 LAUREL BOWIE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4000
Practice Address - Country:US
Practice Address - Phone:410-715-4833
Practice Address - Fax:301-352-0893
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03442111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor