Provider Demographics
NPI:1578191920
Name:YAZDANPANAH, FARIBA
Entity Type:Individual
Prefix:
First Name:FARIBA
Middle Name:
Last Name:YAZDANPANAH
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:UNIVERSITY OF MARYLAND PRINCE GEORGE'S HOSPITAL CENTER
Mailing Address - Street 2:DEPARTMENT OF MEDICINE, 3001 HOSPITAL DRIVE 5TH FLOOR
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785
Mailing Address - Country:US
Mailing Address - Phone:301-618-3772
Mailing Address - Fax:301-618-2986
Practice Address - Street 1:UNIVERSITY OF MARYLAND PRINCE GEORGE'S HOSPITAL CENTER
Practice Address - Street 2:DEPARTMENT OF MEDICINE, 3001 HOSPITAL DRIVE 5TH FLOOR
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785
Practice Address - Country:US
Practice Address - Phone:301-618-3772
Practice Address - Fax:301-618-2986
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program