Provider Demographics
NPI:1689822009
Name:MALAYERI, ASHKAN (MD)
Entity Type:Individual
Prefix:
First Name:ASHKAN
Middle Name:
Last Name:MALAYERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ASHKAN
Other - Middle Name:
Other - Last Name:AKHAVAN MALAYERI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6565 N CHARLES ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6800
Mailing Address - Country:US
Mailing Address - Phone:443-849-2682
Mailing Address - Fax:443-849-8030
Practice Address - Street 1:6565 N CHARLES ST
Practice Address - Street 2:SUITE 203
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-6800
Practice Address - Country:US
Practice Address - Phone:443-849-2682
Practice Address - Fax:443-849-8030
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD758082085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology