Provider Demographics
NPI:1942345970
Name:RAZI, BABAK (MD)
Entity Type:Individual
Prefix:MR
First Name:BABAK
Middle Name:
Last Name:RAZI
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 1:4404 QUEENSBURY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1068
Mailing Address - Country:US
Mailing Address - Phone:301-779-1949
Mailing Address - Fax:301-699-1703
Practice Address - Street 1:4404 QUEENSBURY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1068
Practice Address - Country:US
Practice Address - Phone:301-779-1949
Practice Address - Fax:301-699-1703
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCS0111967207RN0300X
MDD0057039207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H51343Medicare UPIN
MD008382M92Medicare ID - Type Unspecified