Provider Demographics
NPI:1942203930
Name:SOTOUDEH, FARANAK FOROOZANFAR (MD)
Entity Type:Individual
Prefix:DR
First Name:FARANAK
Middle Name:FOROOZANFAR
Last Name:SOTOUDEH
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Gender:F
Credentials:MD
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Mailing Address - Street 1:7501 GREENWAY CENTER DR
Mailing Address - Street 2:SUITE 730
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3514
Mailing Address - Country:US
Mailing Address - Phone:301-474-0400
Mailing Address - Fax:301-474-2686
Practice Address - Street 1:7501 GREENWAY CENTER DR
Practice Address - Street 2:SUITE 730
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3514
Practice Address - Country:US
Practice Address - Phone:301-474-0400
Practice Address - Fax:301-474-2686
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2016-10-03
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Provider Licenses
StateLicense IDTaxonomies
MD15374207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD115811200Medicaid
MD115811200Medicaid
MDG02410F01Medicare PIN