Basic Information
| Provider Information | |||||||||
| NPI: | 1861621211 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DARD | ||||||||
| FirstName: | SHABIR | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2415 MUSGROVE RD | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209045202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3019890193 | ||||||||
| FaxNumber: | 3018792325 | ||||||||
| Practice Location | |||||||||
| Address1: | 2415 MUSGROVE RD | ||||||||
| Address2: | #105 | ||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209045202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3019890193 | ||||||||
| FaxNumber: | 3018792325 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2009 | ||||||||
| LastUpdateDate: | 01/31/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 003727 | GA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | D0075059 | MD | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1861621211 | 01 | MD | NPI | OTHER |