Provider Demographics
NPI:1023091048
Name:NAKAZAWA, HIROSHI (MD)
Entity type:Individual
Prefix:DR
First Name:HIROSHI
Middle Name:
Last Name:NAKAZAWA
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 1:700 GEIPE RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4176
Mailing Address - Country:US
Mailing Address - Phone:410-744-8505
Mailing Address - Fax:410-744-7173
Practice Address - Street 1:700 GEIPE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4176
Practice Address - Country:US
Practice Address - Phone:410-744-8505
Practice Address - Fax:410-744-7173
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDACU021171100000X
MDD0007437208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
C48897Medicare UPIN
6350Medicare ID - Type Unspecified