Provider Demographics
NPI:1609972694
Name:BORHANI, BAHAREH (DC)
Entity Type:Individual
Prefix:DR
First Name:BAHAREH
Middle Name:
Last Name:BORHANI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10903 INDIAN HEAD HWY
Mailing Address - Street 2:#506
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-4000
Mailing Address - Country:US
Mailing Address - Phone:301-292-7500
Mailing Address - Fax:301-203-1511
Practice Address - Street 1:10903 INDIAN HEAD HIGHWAY
Practice Address - Street 2:#506
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-5143
Practice Address - Country:US
Practice Address - Phone:301-292-7500
Practice Address - Fax:301-203-1511
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS02058111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU92644Medicare UPIN
MD00B832F04Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER