Provider Demographics
NPI:1407965056
Name:NAQVI, TEHSEEN RAZA (MD)
Entity Type:Individual
Prefix:
First Name:TEHSEEN
Middle Name:RAZA
Last Name:NAQVI
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 1:18530 OFFICE PARK DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-0586
Mailing Address - Country:US
Mailing Address - Phone:301-769-6640
Mailing Address - Fax:301-769-6650
Practice Address - Street 1:18566 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY VILLAGE
Practice Address - State:MD
Practice Address - Zip Code:20886-0587
Practice Address - Country:US
Practice Address - Phone:301-769-6640
Practice Address - Fax:301-769-6650
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME017608207QG0300X, 207Q00000X
MDD69829207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCE402 0025OtherCAREFIRST
DC171042ZFP8OtherMEDICARE
ME433125599Medicaid
MD4185757900OtherMEDICAL ASSISTANCE
GAP00790390OtherRAILROAD MEDICARE
NH30208167Medicaid
MD96004401OtherCAREFIRST
MD169782ZDVXOtherMEDICARE
MEP00718371Medicare PIN
DC171042ZFP8OtherMEDICARE
ME000968502Medicare PIN
ME000968501Medicare PIN