Provider Demographics
NPI:1427384619
Name:RAMIN FARBOUD MD PC
Entity Type:Organization
Organization Name:RAMIN FARBOUD MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FARBOUDMANESCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-652-4828
Mailing Address - Street 1:5454 WISCONSIN AVENUE
Mailing Address - Street 2:SUITE 1045
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-6917
Mailing Address - Country:US
Mailing Address - Phone:301-652-4828
Mailing Address - Fax:301-652-2070
Practice Address - Street 1:1160 VARNUM ST NE
Practice Address - Street 2:SUITE 212
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2107
Practice Address - Country:US
Practice Address - Phone:301-652-4828
Practice Address - Fax:301-652-2070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-23
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD33797207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty