Provider Demographics
NPI:1205183126
Name:SOHI, MOJGAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MOJGAN
Middle Name:
Last Name:SOHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MOJGAN
Other - Middle Name:M
Other - Last Name:SOHI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6712 NEWSTEAD LN
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2004
Mailing Address - Country:US
Mailing Address - Phone:312-929-6864
Mailing Address - Fax:
Practice Address - Street 1:6701 N CHARLES ST
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-6808
Practice Address - Country:US
Practice Address - Phone:312-929-6864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD81872208M00000X, 207R00000X
IL125062439207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD111461100Medicaid
IL1205183126OtherNPI NUMBER