Provider Demographics
NPI:1790714681
Name:CALAF, NIMA HASSAN (MD)
Entity Type:Individual
Prefix:
First Name:NIMA
Middle Name:HASSAN
Last Name:CALAF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4467 OLD BRANCH AVE
Mailing Address - Street 2:STE 203
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-1854
Mailing Address - Country:US
Mailing Address - Phone:301-899-1212
Mailing Address - Fax:301-899-3716
Practice Address - Street 1:4467 OLD BRANCH AVE
Practice Address - Street 2:STE 203
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-1854
Practice Address - Country:US
Practice Address - Phone:301-899-1212
Practice Address - Fax:301-899-3716
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0058976207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCJ443-0013OtherCAREFIRST BLUE SHIELD
DCP00312949OtherRAIL ROAD MEDICARE
DC015802M28Medicare PIN
DCP00312949OtherRAIL ROAD MEDICARE