Provider Demographics
NPI:1326019357
Name:YAZDANI, ARASTOO (MD)
Entity Type:Individual
Prefix:DR
First Name:ARASTOO
Middle Name:
Last Name:YAZDANI
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:PO BOX 2636
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20195-0636
Mailing Address - Country:US
Mailing Address - Phone:301-877-2150
Mailing Address - Fax:301-877-2154
Practice Address - Street 1:9135 PISCATAWAY RD
Practice Address - Street 2:SUITE 235
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-2549
Practice Address - Country:US
Practice Address - Phone:301-877-2150
Practice Address - Fax:301-877-2154
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0050454207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD158008600Medicaid
MD541181500Medicaid
MDG01511Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
G44484Medicare UPIN
MD541181500Medicaid