Provider Demographics
NPI:1598786840
Name:GOHARI, ABOLGHASSEM MASUD (MD)
Entity Type:Individual
Prefix:DR
First Name:ABOLGHASSEM
Middle Name:MASUD
Last Name:GOHARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5915 GREENBELT RD
Mailing Address - Street 2:
Mailing Address - City:BERWYN HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20740-2259
Mailing Address - Country:US
Mailing Address - Phone:301-474-5300
Mailing Address - Fax:301-441-3200
Practice Address - Street 1:5915 GREENBELT RD
Practice Address - Street 2:
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740-2259
Practice Address - Country:US
Practice Address - Phone:301-474-5300
Practice Address - Fax:301-441-3200
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0018165207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC62288Medicare UPIN