Provider Demographics
NPI:1962449215
Name:IDRISS, ZIAD HASSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ZIAD
Middle Name:HASSAN
Last Name:IDRISS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5301 WESTBARD CIRCLE
Mailing Address - Street 2:#3
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816
Mailing Address - Country:US
Mailing Address - Phone:301-654-6303
Mailing Address - Fax:301-654-6304
Practice Address - Street 1:5301 WESTBARD CIRCLE
Practice Address - Street 2:#3
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817
Practice Address - Country:US
Practice Address - Phone:301-654-6303
Practice Address - Fax:301-654-6304
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD28809208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics