Provider Demographics
NPI:1790797298
Name:DADGAR-DEHKORDI, IRADJ (MD)
Entity Type:Individual
Prefix:DR
First Name:IRADJ
Middle Name:
Last Name:DADGAR-DEHKORDI
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:PO BOX 1625
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20849-1625
Mailing Address - Country:US
Mailing Address - Phone:240-403-3322
Mailing Address - Fax:301-983-4285
Practice Address - Street 1:7801 OLD BRANCH AVE
Practice Address - Street 2:SUITE 409
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-1608
Practice Address - Country:US
Practice Address - Phone:240-403-3322
Practice Address - Fax:301-983-4285
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0014827208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)