Provider Demographics
NPI:1265671465
Name:DADGAR, SHABNAM (MD)
Entity Type:Individual
Prefix:DR
First Name:SHABNAM
Middle Name:
Last Name:DADGAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 RESEARCH BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6233
Mailing Address - Country:US
Mailing Address - Phone:240-912-4546
Mailing Address - Fax:
Practice Address - Street 1:2403 RESEARCH BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6233
Practice Address - Country:US
Practice Address - Phone:240-912-4546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-11
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD72779207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology