Provider Demographics
NPI:1477814903
Name:MAHMOOD MOHAMADI, M.D, PA
Entity Type:Organization
Organization Name:MAHMOOD MOHAMADI, M.D, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAHMOOD
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:301-567-9570
Mailing Address - Street 1:6130 OXON HILL RD
Mailing Address - Street 2:SUITE # 204
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3103
Mailing Address - Country:US
Mailing Address - Phone:301-567-9570
Mailing Address - Fax:301-567-5290
Practice Address - Street 1:6130 OXON HILL RD
Practice Address - Street 2:SUITE # 204
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3103
Practice Address - Country:US
Practice Address - Phone:301-567-9570
Practice Address - Fax:301-567-5290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty