Individual
DR. KIOUMARCE YAZDANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2555 SOLOMONS ISLAND RD, HUNTINGTOWN, MD 20639-8734
(410) 535-1695
(410) 535-8684
Mailing address
PO BOX 70, HUNTINGTOWN, MD 20639-0070
(410) 535-1695
(410) 535-8684
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
D0017168
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110023678
MEDICARE RAILROAD
—
01
—
219077
OPTIMUM CHOICE
MD
01
—
76450001
BC/BS MD
MD
Enumeration date
09/07/2005
Last updated
07/24/2008
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