Provider Demographics
NPI:1497911028
Name:BAHRAM ERFAN, MD PA
Entity Type:Organization
Organization Name:BAHRAM ERFAN, MD PA
Other - Org Name:PG VASCULAR DIAGNOSTIC CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BAHRAM
Authorized Official - Middle Name:N
Authorized Official - Last Name:ERFAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-881-8076
Mailing Address - Street 1:6510 KENILWORTH AVE
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1339
Mailing Address - Country:US
Mailing Address - Phone:301-927-6111
Mailing Address - Fax:
Practice Address - Street 1:6510 KENILWORTH AVE
Practice Address - Street 2:SUITE 2500
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1339
Practice Address - Country:US
Practice Address - Phone:301-927-6111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-04
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty