Provider Demographics
NPI:1598150278
Name:HOSSEINI, SAYED MOHAMMAD (MD)
Entity Type:Individual
Prefix:
First Name:SAYED MOHAMMAD
Middle Name:
Last Name:HOSSEINI
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 1:101 S ELLWOOD AVE
Mailing Address - Street 2:APT 435
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-2270
Mailing Address - Country:US
Mailing Address - Phone:443-839-5332
Mailing Address - Fax:
Practice Address - Street 1:101 S ELLWOOD AVE
Practice Address - Street 2:APT 435
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2270
Practice Address - Country:US
Practice Address - Phone:443-839-5332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-31
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0088557207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program