Provider Demographics
NPI:1275549081
Name:NASSABEH, SEPIDEH (MD)
Entity Type:Individual
Prefix:DR
First Name:SEPIDEH
Middle Name:
Last Name:NASSABEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SEPIDEH
Other - Middle Name:
Other - Last Name:MONTAZAMI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3001 HOSPITAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785
Mailing Address - Country:US
Mailing Address - Phone:301-618-2000
Mailing Address - Fax:
Practice Address - Street 1:3001 HOSPITAL DRIVE
Practice Address - Street 2:NEONATAL INTENSIVE CARE UNIT, PRINCE GEORGES HOSPITAL
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785
Practice Address - Country:US
Practice Address - Phone:301-618-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD0352792080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
020618M65Medicare PIN