Provider Demographics
NPI:1447632666
Name:MEHDI KHABAZIAN, BEHZAD (DPT)
Entity type:Individual
Prefix:MR
First Name:BEHZAD
Middle Name:
Last Name:MEHDI KHABAZIAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:BEHZAD
Other - Middle Name:
Other - Last Name:KHABAZIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7500 HANOVER PKWY
Mailing Address - Street 2:STE 103.
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770
Mailing Address - Country:US
Mailing Address - Phone:301-446-1644
Mailing Address - Fax:301-446-1647
Practice Address - Street 1:17902 GEORGIA AVE
Practice Address - Street 2:STE 100
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832
Practice Address - Country:US
Practice Address - Phone:301-774-1789
Practice Address - Fax:301-774-1394
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25511225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist