Provider Demographics
NPI:1639182041
Name:ZARGARIAN, EMMA (MD)
Entity Type:Individual
Prefix:DR
First Name:EMMA
Middle Name:
Last Name:ZARGARIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EMMA
Other - Middle Name:
Other - Last Name:ZARGARIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6565 N CHARLES ST
Mailing Address - Street 2:SUITE 501
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6800
Mailing Address - Country:US
Mailing Address - Phone:410-828-8369
Mailing Address - Fax:410-583-7470
Practice Address - Street 1:6565 N CHARLES ST
Practice Address - Street 2:SUITE 501
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-6800
Practice Address - Country:US
Practice Address - Phone:410-828-8369
Practice Address - Fax:410-583-7470
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD22704174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB70119Medicare UPIN
MD200NMedicare ID - Type Unspecified