Provider Demographics
NPI:1225069701
Name:ALIABADI, FARHAD (MD)
Entity Type:Individual
Prefix:DR
First Name:FARHAD
Middle Name:
Last Name:ALIABADI
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 1:10011 DICKENS AVE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2107
Mailing Address - Country:US
Mailing Address - Phone:410-721-2273
Mailing Address - Fax:
Practice Address - Street 1:2225 DEFENSE HWY STE E
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2468
Practice Address - Country:US
Practice Address - Phone:410-721-2273
Practice Address - Fax:443-332-4265
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0029893208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD351101400Medicaid
MD155NL380Medicare ID - Type Unspecified
MD351101400Medicaid