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Organization

PROVIDENCE MENTAL HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ABDOLAZIM SHAHSAVAR MD (PHYSICIAN AND THE PRACTICE OWNER)
(571) 331-8617
Entity
Organization

Contact information

Practice address
2345 YORK RD STE 201, TIMONIUM, MD 21093-2279
(571) 331-8617
Mailing address
527 CHATTERTON RD, TIMONIUM, MD 21093-1934
(571) 331-8617

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary

Other

Enumeration date
03/14/2019
Last updated
03/15/2019
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