| Nader Tavakoli Pa Inc | |
|
9500 Medical Center Drive Suite 230-f Largo MD 20774 | |
| (301) 352-7118 | |
| (301) 352-7779 |
| Full Name | Nader Tavakoli Pa Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 9500 Medical Center Drive Suite 230-f, Largo, Maryland |
| Authorized Official Name and Position | Nader Tavakoli-jalili (PRESIDENT) |
| Authorized Official Contact | 3013527118 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nader Tavakoli Pa Inc 626 Admiral Dr Suite C #235 Annapolis MD 21401-2151 Ph: (301) 352-7118 | Nader Tavakoli Pa Inc 9500 Medical Center Drive Suite 230-f Largo MD 20774 Ph: (301) 352-7118 |
| NPI Number | 1346348075 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 08/25/2021 |
| Medicare PECOS PAC ID | 8426000209 |
|---|---|
| Medicare Enrollment ID | O20050221000398 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346348075 | NPI | - | NPPES |
| 305791700 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207QA0505X | Family Medicine - Adult Medicine | D41978 (Maryland) | Secondary |
| Provider Name | Nader Tavakoli-jalili |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407059413 PECOS PAC ID: 0143272922 Enrollment ID: I20100921000678 |
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Ibe Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9500 Medical Center Dr Ste 105, Largo, MD 20774 Phone: 301-615-4133 Fax: 240-245-2918 | |
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