Provider Demographics
NPI:1942302450
Name:RASHIDIAN, AMIR (DC)
Entity Type:Individual
Prefix:
First Name:AMIR
Middle Name:
Last Name:RASHIDIAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7196 CRESTWOOD BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-1844
Mailing Address - Country:US
Mailing Address - Phone:301-698-0001
Mailing Address - Fax:301-698-0031
Practice Address - Street 1:7196 CRESTWOOD BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-1844
Practice Address - Country:US
Practice Address - Phone:301-698-0001
Practice Address - Fax:301-698-0031
Is Sole Proprietor?:No
Enumeration Date:2006-09-04
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02013111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG9030002OtherCF DC
MD61851601OtherCF MD
MDU94410Medicare UPIN
MD539MMedicare ID - Type Unspecified