Provider Demographics
NPI:1063664217
Name:KIUMARCE KASHI MD PC
Entity Type:Organization
Organization Name:KIUMARCE KASHI MD PC
Other - Org Name:BALTIMORE SLEEP AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIUMARCE
Authorized Official - Middle Name:
Authorized Official - Last Name:KASHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-284-3322
Mailing Address - Street 1:6830 HOSPITAL DRIVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237
Mailing Address - Country:US
Mailing Address - Phone:410-284-3322
Mailing Address - Fax:410-284-7204
Practice Address - Street 1:6830 HOSPITAL DR
Practice Address - Street 2:SUITE 106
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4373
Practice Address - Country:US
Practice Address - Phone:410-284-3322
Practice Address - Fax:410-284-7204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0047658261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD372481600Medicaid
MD6692820001Medicare NSC
MD019RMedicare PIN
MD372481600Medicaid