Provider Demographics
NPI:1346877735
Name:MOBARAKEH, KAYVON MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:KAYVON
Middle Name:MICHAEL
Last Name:MOBARAKEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF MARYLAND DEPARTMENT OF ANESTHESIOLOGY
Mailing Address - Street 2:22 S GREENE ST, S11C
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201
Mailing Address - Country:US
Mailing Address - Phone:410-328-1239
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF MARYLAND DEPARTMENT OF ANESTHESIOLOGY
Practice Address - Street 2:22 S GREENE ST, S11C
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201
Practice Address - Country:US
Practice Address - Phone:410-328-1239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0098756207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine