Provider Demographics
NPI:1659605657
Name:YOUSEFI, ARASH (DC)
Entity Type:Individual
Prefix:
First Name:ARASH
Middle Name:
Last Name:YOUSEFI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MORNING LIGHT CT
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2093
Mailing Address - Country:US
Mailing Address - Phone:410-761-7955
Mailing Address - Fax:470-761-3245
Practice Address - Street 1:337 HOSPITAL DRIVE
Practice Address - Street 2:SUITE F
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061
Practice Address - Country:UM
Practice Address - Phone:410-761-7955
Practice Address - Fax:410-761-3245
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03590111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDAP09OtherBLUE CROSS BLUE SHIELD