Provider Demographics
NPI:1629055744
Name:CHARAFEDDINE, RIAD (MD)
Entity Type:Individual
Prefix:
First Name:RIAD
Middle Name:
Last Name:CHARAFEDDINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7503 SURRATTS ROAD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-3395
Mailing Address - Country:US
Mailing Address - Phone:301-870-7001
Mailing Address - Fax:301-870-6697
Practice Address - Street 1:7503 SURRATTS ROAD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-3395
Practice Address - Country:US
Practice Address - Phone:202-877-6429
Practice Address - Fax:202-877-8626
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD0373852085R0202X
MDD680212085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology