Provider Demographics
NPI:1942221197
Name:VASDEV, PRIYA (MD)
Entity Type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:VASDEV
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:515 FAIRMOUNT AVE
Mailing Address - Street 2:SUITE 900
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5466
Mailing Address - Country:US
Mailing Address - Phone:202-383-6509
Mailing Address - Fax:610-612-3841
Practice Address - Street 1:15005 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1017
Practice Address - Country:US
Practice Address - Phone:202-383-6509
Practice Address - Fax:610-612-3841
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDMD77747207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011844600001Medicaid
PA1011844600001Medicaid
PA082204Medicare PIN