Provider Demographics
NPI:1265593305
Name:AMIRSHAHI, MARYANN ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:MARYANN
Middle Name:ELIZABETH
Last Name:AMIRSHAHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARYANN
Other - Middle Name:ELIZABETH
Other - Last Name:MAZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:110 IRVING ST NW
Mailing Address - Street 2:DEPARTMENT OF EMERGENCY MEDICINE
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-3017
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:DEPARTMENT OF EMERGENCY MEDICINE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3017
Practice Address - Country:US
Practice Address - Phone:215-219-0242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD038574207PT0002X, 207RA0401X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical Toxicology
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine