Individual
DR. SHAHAB ZARE BAVANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7300 VAN DUSEN RD, LAUREL, MD 20707-9463
(410) 730-7440
(414) 073-0747
Mailing address
10724 LITTLE PATUXENT PKWY STE 200, COLUMBIA, MD 21044-3249
(410) 997-5944
(410) 997-1720
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0064874
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6800
—
MD
Enumeration date
07/26/2006
Last updated
03/05/2009
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