Provider Demographics
NPI:1689832495
Name:A. REZA FAMILI,MD,LLC
Entity Type:Organization
Organization Name:A. REZA FAMILI,MD,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:REZA
Authorized Official - Last Name:FAMILI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-997-1334
Mailing Address - Street 1:10116 VANDERBILT CIR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4674
Mailing Address - Country:US
Mailing Address - Phone:240-997-1334
Mailing Address - Fax:301-987-9505
Practice Address - Street 1:9801 GEORGIA AVE
Practice Address - Street 2:332
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5276
Practice Address - Country:US
Practice Address - Phone:240-997-1334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0060420261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care