Provider Demographics
NPI:1275569204
Name:MIAN, RAFIQ A (MD)
Entity Type:Individual
Prefix:DR
First Name:RAFIQ
Middle Name:A
Last Name:MIAN
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 1:1400 FOREST GLEN RD
Mailing Address - Street 2:SUITE 235
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1459
Mailing Address - Country:US
Mailing Address - Phone:301-754-0450
Mailing Address - Fax:301-754-0657
Practice Address - Street 1:1400 FOREST GLEN RD
Practice Address - Street 2:SUITE 235
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1459
Practice Address - Country:US
Practice Address - Phone:301-754-0450
Practice Address - Fax:301-754-0657
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0026153207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH384RAOtherBLUE SHIELD OF MD
MD257961800Medicaid
DC74620001OtherBLUE SHIELD OF DC
MD04725OtherAMERIGROUP
MD0122555OtherAETNA
MD257961800Medicaid
MDD26153Medicare UPIN