Provider Demographics
NPI:1740444181
Name:MARZBAN, MEHRAK MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:MEHRAK
Middle Name:MICHAEL
Last Name:MARZBAN
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 1:831 UNIVERSITY BLVD E STE 11
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-2921
Mailing Address - Country:US
Mailing Address - Phone:301-431-0431
Mailing Address - Fax:301-431-0470
Practice Address - Street 1:831 UNIVERSITY BLVD E STE 11
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-2921
Practice Address - Country:US
Practice Address - Phone:301-431-0431
Practice Address - Fax:301-431-0470
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0074318207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD055195300Medicaid
MD244045ZE3MOtherMEDICARE
MDD0074318OtherPHYSICIAN LICENSE