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Individual

VAHID ETEZADI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
22 S GREENE ST, DEPT OF RADIOLOGY, BALTIMORE, MD 21201-1544
(410) 328-3477
Mailing address
8712 SNOWHILL CT, POTOMAC, MD 20854-4411
(786) 333-7599

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
D0082037
MD
2085R0204X
Vascular & Interventional Radiology Physician
Primary
D0082037
MD
2085R0204X
Vascular & Interventional Radiology Physician
MD210012388
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
024995813
DC
05
100494801
MD
Enumeration date
05/24/2010
Last updated
11/20/2023
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