Individual
ANTORA YAZDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
KAISER PERMANENTE WEST HYATTSVILLE MEDICAL CENTER, 5620 AGER RD, HYATTSVILLE, MD 20782
(800) 777-7904
Mailing address
5620 AGER RD STE 2312, HYATTSVILLE, MD 20782-3729
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H91414
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/14/2018
Last updated
09/06/2022
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