Individual
ALIREZA HAZRATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRFNP-BC
Contact information
Practice address
74 THOMAS JOHNSON DR, FREDERICK, MD 21702-4501
(301) 694-9033
(301) 694-6204
Mailing address
74 THOMAS JOHNSON DR, FREDERICK, MD 21702-4501
(301) 694-9033
(301) 694-6204
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN0000180274
TN
363LF0000X
Family Nurse Practitioner
Primary
AC001852
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1459-0013
CAREFIRST
—
01
—
342524
JOHNS HOPKINS HEALTHCARE
—
01
—
5508603
CIGNA
—
01
—
6445113
AETNA
—
01
—
652580
MEDICARE
—
01
—
6734677
UNITED HEALTHCARE
—
05
—
794014900
—
MD
01
—
P02079605
RAILROAD MEDICARE
—
Enumeration date
02/18/2015
Last updated
09/25/2019
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