Provider Demographics
NPI:1871733790
Name:DAHYDARBANDI, MOHEBAT (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MOHEBAT
Middle Name:
Last Name:DAHYDARBANDI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8048 TUCKERMAN LN
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3740
Mailing Address - Country:US
Mailing Address - Phone:301-437-6044
Mailing Address - Fax:
Practice Address - Street 1:8048 TUCKERMAN LN
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-3740
Practice Address - Country:US
Practice Address - Phone:301-437-6044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002572363A00000X
VA0110002721363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant