Provider Demographics
NPI:1609294719
Name:KAMALI, ATENA
Entity Type:Individual
Prefix:
First Name:ATENA
Middle Name:
Last Name:KAMALI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4940 EASTERN AVE
Mailing Address - Street 2:RANDY PARKER MEDICAL GROUP, 301 BUILDING
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-2735
Mailing Address - Country:US
Mailing Address - Phone:410-550-3350
Mailing Address - Fax:410-550-1094
Practice Address - Street 1:4940 EASTERN AVE
Practice Address - Street 2:RANDY PARKER MEDICAL GROUP, 301 BUILDING
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2735
Practice Address - Country:US
Practice Address - Phone:410-550-3350
Practice Address - Fax:410-550-1094
Is Sole Proprietor?:No
Enumeration Date:2014-04-04
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD82147208M00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist