Provider Demographics
NPI:1255649695
Name:AMIRSHAHI SHIRAZI, BABAK (MD)
Entity Type:Individual
Prefix:DR
First Name:BABAK
Middle Name:
Last Name:AMIRSHAHI SHIRAZI
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 1:7907 KREEGER DR APT 201
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-4460
Mailing Address - Country:US
Mailing Address - Phone:301-254-4237
Mailing Address - Fax:
Practice Address - Street 1:7907 KREEGER DR APT 201
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-4460
Practice Address - Country:US
Practice Address - Phone:301-254-4237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD75571208M00000X, 207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program