Bahram Pishdad, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

D0051520 Issued in MD

Practice address

600 Largo Rd
Largo, MD 20774-2122

Phone

(703) 855-1036

Fax

(703) 255-5378

NPI assigned

Nov 8, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1265502389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8220 CRESTWOOD HEIGHTS DR",
            "address_2": "APT 607",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023129",
            "telephone_number": "703-855-1036",
            "fax_number": "703-255-5378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 LARGO RD",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207742122",
            "telephone_number": "703-855-1036",
            "fax_number": "703-255-5378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7420 Marlboro Pike",
            "address_purpose": "LOCATION",
            "city": "Forestville",
            "state": "MD",
            "postal_code": "207474343",
            "country_code": "US",
            "telephone_number": "703-855-1036",
            "fax_number": "703-255-5378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8220 CRESTWOOD HEIGHTS DR",
            "address_2": "APT 607",
            "address_purpose": "LOCATION",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023129",
            "country_code": "US",
            "telephone_number": "703-855-1036",
            "fax_number": "703-255-5378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PISHDAD",
        "first_name": "BAHRAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101052350",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0051520",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "DC",
            "license": "MD21812",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MD",
            "license": "D0051520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "795007100",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017251600",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Largo, MD
• Providers in Largo, MD by specialty
• General Practice Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.