Provider Demographics
NPI:1447518030
Name:MEZAD KOURSH, DAPHNA (MD)
Entity type:Individual
Prefix:
First Name:DAPHNA
Middle Name:
Last Name:MEZAD KOURSH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:111 MICHIGAN AVE NW
Mailing Address - Street 2:CHILDREN'S NATIONAL MEDICAL CENTER
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2916
Mailing Address - Country:US
Mailing Address - Phone:202-476-5774
Mailing Address - Fax:202-741-4741
Practice Address - Street 1:111 MICHIGAN AVE NW
Practice Address - Street 2:CHILDREN'S NATIONAL MEDICAL CENTER
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2916
Practice Address - Country:US
Practice Address - Phone:202-476-5774
Practice Address - Fax:202-741-4741
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2012-07-30
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Provider Licenses
StateLicense IDTaxonomies
DCMTL000103207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology