Organization
MARYLAND RETINA INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAZA MURTAZA SHAH MD (PHYSICIAN)
(301) 876-4900
Entity
Organization
Contact information
Practice address
2919 OLNEY SANDY SPRING RD STE D, OLNEY, MD 20832
(301) 876-4900
Mailing address
2919 OLNEY SANDY SPRING RD STE D, OLNEY, MD 20832-1589
(301) 876-4900
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07207311
AMERIGROUP
MD
01
—
1205098910
UNITEDHEALTHCARE
MD
01
—
49280003
CAREFIRST BLUECROSS BLUESHIELD
MD
05
—
658406300
—
MD
Enumeration date
10/18/2017
Last updated
06/14/2018
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