Provider Demographics
NPI:1740362904
Name:NOURANI ZENUZ, SIMA (MD)
Entity type:Individual
Prefix:
First Name:SIMA
Middle Name:
Last Name:NOURANI ZENUZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 WYMAN PARK DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-2803
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5215 LOUGHBORO RD NW STE 300
Practice Address - Street 2:JHCP @ SIBLEY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2626
Practice Address - Country:US
Practice Address - Phone:202-243-4480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101239152207R00000X, 208M00000X
MDD0065182207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD415096100Medicaid
MD415096100Medicaid