Provider Demographics
NPI:1679557433
Name:ERFAN, BAHRAM NMI (MD)
Entity type:Individual
Prefix:
First Name:BAHRAM
Middle Name:NMI
Last Name:ERFAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2006
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20768-2006
Mailing Address - Country:US
Mailing Address - Phone:301-881-8076
Mailing Address - Fax:
Practice Address - Street 1:5802 NICHOLSON LN APT 804
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2967
Practice Address - Country:US
Practice Address - Phone:301-881-8076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDO002236208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD115181900Medicaid
DC166763Medicare PIN
B93909Medicare UPIN