Individual
ABDOLLAH SHAMS PIRZADEH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
716 MAIDEN CHOICE LN, SUITE 301, BALTIMORE, MD 21228-5943
(410) 788-2000
(410) 455-9881
Mailing address
716 MAIDEN CHOICE LN, SUITE 301, BALTIMORE, MD 21228-5943
(410) 788-2000
(410) 465-9881
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
D0014789
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00941-1800
—
MA
01
—
111923152
RAILROAD MEDICARE
MD
01
—
222430
MAMSI/OPT CHOICE
MD
01
—
36198001
BLUE CROSS BLUE SHIELD
MD
01
—
521190322
TAX ID #
MD
01
—
W0410001
FEDERAL BCBS
MD
Enumeration date
11/01/2006
Last updated
07/25/2012
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