Organization
KHOSROW DAVACHI MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHOSROW DAVACHI MD (PRESIDENT OWNER)
(301) 868-7121
Entity
Organization
Contact information
Practice address
7700 OLD BRANCH AVE STE D203, CLINTON, MD 20735-1611
(301) 868-7121
(301) 877-1934
Mailing address
7700 OLD BRANCH AVE STE D203, CLINTON, MD 20735-1611
(301) 868-7121
(301) 868-7968
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
D0025640
MD
207RN0300X
Nephrology Physician
MD8172
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048343500
—
DC
05
—
05722
—
DC
05
—
05722
—
MD
01
—
0734041012
CIGNA
—
01
—
0771 0001
BX DC
DC
01
—
097999
ANTHEM BX
VA
05
—
10094
—
DC
01
—
175743
MEDICARE
—
05
—
205102800
—
MD
05
—
27555
—
MD
01
—
30859001
BX MARYLAND
MD
01
—
4050444
AETNA
—
01
—
417465
MAMSI
—
05
—
4954
—
DC
01
—
CH8837
RAILROAD MEDICARE
DC
01
—
CH8837
RAILROAD MEDICARE
MD
Enumeration date
05/21/2007
Last updated
07/09/2025
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