Individual
MANDANA SHAHBAZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
25 MAIN STREET, SUITE 200, REISTERSTOWN, MD 21136
(410) 526-8310
(410) 526-8316
Mailing address
25 MAIN STREET, SUITE 200, REISTERSTOWN, MD 21136
(410) 526-8310
(410) 526-8316
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0063534
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
408809300
—
MD
Enumeration date
01/25/2006
Last updated
01/14/2014
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