KHOSROW DAVACHI MD PC (NPI# 1295944957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295944957 |
| Entity Type | Organization |
| Organization Name | KHOSROW DAVACHI MD PC |
| Practice Address |
7700 Old Branch Ave Ste D203 Clinton MD 20735-1611 |
| Practice Telephone | 3018687121 |
| Practice Fax Number | 3018771934 |
| Mailing Telephone | 3018687121 |
| Mailing Fax Number | 3018771934 |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2018-09-17 |
| Authorized Official Name | DR. KHOSROW DAVACHI (PRESIDENT OWNER) |
| Authorized Official Telephone | 3018687121 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
D0025640 | MD | Allopathic & Osteopathic Physicians |
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
MD8172 | DC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DC | 05722 | 05 | |
| MD | 05722 | 05 | |
| MEDICARE | 175743 | 01 | |
| MD | BX MARYLAND | 30859001 | 01 |
| DC | 10094 | 05 | |
| DC | BX DC | 0771 0001 | 01 |
| DC | BLUE CHOICE | 0771 0001 | 01 |
| MD | 205102800 | 05 | |
| DC | 4954 | 05 | |
| DC | 048343500 | 05 | |
| CIGNA | 0734041012 | 01 | |
| MD | 27555 | 05 | |
| AETNA | 4050444 | 01 | |
| MAMSI | 417465 | 01 | |
| VA | ANTHEM BX | 097999 | 01 |
| MD | RAILROAD MEDICARE | CH8837 | 01 |
| DC | RAILROAD MEDICARE | CH8837 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1328 Southern Ave Se, Suite 310, Washington, DC 200324689 | 2025620400 | 2025629619 |
| Street Address |
7700 OLD BRANCH AVE STE D203 |
| City | CLINTON |
| State | MD |
| Zip Code | 20735-1611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760940456 | Elise Olson | Occupational Therapist | 9135 Piscataway Rd, Suite 305, Clinton, MD 20735 | 2019-03-12 |
| 1437651742 | Total You Integrative Healthcare Inc | Clinic/Center | 9135 Piscataway Rd Ste 410, Clinton, MD 20735 | 2018-03-02 |
| 1386193233 | Benedicta C Osamor | Home Health Aide | 6808 Purple Lilac Ln, Clinton, MD 20735 | 2016-10-03 |
| 1669926309 | Frankline Ngozi Obi I | Home Health Aide | 8111 Highland Meadows Dr, Clinton, MD 20735 | 2016-08-11 |
| 1770952459 | Adventures One, Inc. | Clinic/Center | 7121 Old Alexandria Ferry Rd., Clinton, MD 20735 | 2015-09-23 |
| 1730574831 | Lindsey Degeorge | Emergency Medicine | 7503 Surratts Rd Dept Of, Clinton, MD 20735 | 2015-04-06 |
| 1316341860 | Margaret Laurence-whitlock | Speech-Language Pathologist | 5807 Terence Dr., Laurence Learning Center, Clinton, MD 20735 | 2014-10-13 |
| 1699103622 | Dcps | Social Worker | 5504 Trout Run Rd, Clinton, MD 20735 | 2013-10-30 |
| 1902232614 | Rafael Antonio Acosta | Dentist | 7905 Malcolm Rd Ste 300, Clinton, MD 20735 | 2013-09-25 |
| 1407135874 | Richelle Wilson Harvey | Occupational Therapist | 8202 Shackelford Way, Clinton, MD 20735 | 2011-08-16 |
| Find all providers in zip 20735 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801391933 | Southern Maryland Nephrology and Hypertension | Internal Medicine | 9131 Piscataway Rd Ste 750, Clinton, MD 20735-2581 | 2018-03-29 |
| 1780094219 | Harshal P Shah | Internal Medicine | 8926 Woodyard Rd Ste 602, Clinton, MD 20735-4235 | 2014-05-06 |
| 1770592446 | Arastoo Yazdani Md PC | Internal Medicine | 9135 Piscataway Road, Suite 235, Clinton, MD 20735 | 2006-08-05 |
| 1225238413 | Kidney and Hypertension Center of In, PC | Internal Medicine | 700 S Main St, Clinton, IN 47842-2420 | 2007-07-25 |
| 1770627176 | Marc Francis Brazie | Internal Medicine | 7801 Old Branch Ave, Suite 202, Clinton, MD 20735-1642 | 2007-02-18 |
| 1013059054 | Cindy Xin Huang | Internal Medicine | 10403 Hospital Dr Ste G7, Clinton, MD 20735-3138 | 2007-02-13 |
| 1487602553 | Anis U Ansari | Internal Medicine | 915 13th Ave N, Clinton, IA 52732-5067 | 2006-05-04 |
| 1255389193 | Andrew David Howard | Internal Medicine | 7801 Old Branch Ave, Suite 202, Clinton, MD 20735-1608 | 2006-05-04 |
| 1508814443 | Manoj Soma Reddy | Internal Medicine | 7801 Old Branch Ave, Suite 202, Clinton, MD 20735-1608 | 2006-05-04 |
| 1942268198 | Metropolitan Nephrology Associates PC | Internal Medicine | 7801 Old Branch Ave, Suite 202, Clinton, MD 20735-1608 | 2006-05-03 |
| Find all providers in CLINTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.