Provider Demographics
NPI:1356846315
Name:HAERI, MITRA HASHEMI (MD)
Entity Type:Individual
Prefix:DR
First Name:MITRA
Middle Name:HASHEMI
Last Name:HAERI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8555 16TH ST STE 310
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2802
Mailing Address - Country:US
Mailing Address - Phone:301-562-7200
Mailing Address - Fax:
Practice Address - Street 1:5454 WISCONSIN AVE STE 1720
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6905
Practice Address - Country:US
Practice Address - Phone:301-562-7200
Practice Address - Fax:301-563-7198
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-29
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD990942084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology