Behnaz Fayazi, M.D.,LLC.
Organization Active NPI Plastic and Reconstructive Surgery Physician · Chevy Chase, MD
NPI 1407082019 · NPPES record last updated Jul 24, 2009
Key facts
- NPI
- 1407082019
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Plastic and Reconstructive Surgery Physician 2086S0122X
- License
- D00068649 (MD)
- Legal business name
- BEHNAZ FAYAZI, M.D.,LLC.
- Practice address
- 5530 Wisconsin Ave
Suite 1248
Chevy Chase, MD 20815-4404 - Phone
- (301) 525-9994
- Fax
- (301) 263-7141
- NPI assigned
- Jun 9, 2009
- Organization subpart
- No
Authorized official
- Name
- Behnaz Fayazi, M.D.
- Title
- Sole Member
- Phone
- (301) 525-9994
Practitioners 1
-
Behnaz Fayazi, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090901000633 | DC | Part B Supplier - Clinic/Group Practice | 1759436439 |
Receives reassigned benefits from 1 practitioner Practice locations: Chevy Chase, MD; Greenbelt, MD |
National Provider Directory
Locations
8401 Connecticut Ave
Ste 107
Chevy Chase, MD 20815
Phone (301) 215-7550
7525 Greenway Center Dr
Ste T3
Greenbelt, MD 20770
Phone (301) 441-1800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician |
2086S0122X | D00068649 | MD | Yes |
Addresses
Primary practice location
5530 Wisconsin Ave
Suite 1248
Chevy Chase, MD 20815-4404
Mailing address
11221 Mitscher St
Kensington, MD 20895-1329
Other providers in Chevy Chase, MD
- Alona Bauer
- Antonia L Baum
- Vivian Bauman
- Bay Area Radiology, PC
- Behavioral Health Solutions, LLC
- Melissa E Belanger
- Katherine Bell
- Belmont Aesthetic & Reconstructive Plastic Surgery
- Belmont Surgery Center, L.L.C.
- Catherine S Bennet
All providers in Chevy Chase, MD · Plastic and Reconstructive Surgery Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.