Provider Demographics
NPI:1659425601
Name:KASHANI, AMIR HOSSEIN (BS, MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:AMIR
Middle Name:HOSSEIN
Last Name:KASHANI
Suffix:
Gender:M
Credentials:BS, MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:
Practice Address - Street 1:600 N WOLFE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-614-4211
Practice Address - Fax:410-500-4262
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101878207W00000X
MI4301098254207W00000X
MDD90697207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI381946761OtherTAX ID
MI1215003793OtherGROUP NPI
MI1659425601Medicaid
MI0Q26082053Medicare PIN