Provider Demographics
NPI:1407502685
Name:ASGARI, SAMINEH
Entity Type:Individual
Prefix:
First Name:SAMINEH
Middle Name:
Last Name:ASGARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12111 DARNESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3211
Mailing Address - Country:US
Mailing Address - Phone:301-782-2224
Mailing Address - Fax:
Practice Address - Street 1:12111 DARNESTOWN RD
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-3211
Practice Address - Country:US
Practice Address - Phone:301-782-2224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-25
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110008442363A00000X
MDC0008363363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant