Provider Demographics
NPI:1861846958
Name:HASHEMIPOUR, REZA
Entity Type:Individual
Prefix:
First Name:REZA
Middle Name:
Last Name:HASHEMIPOUR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19851 OBSERVATION DR STE 245
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-4151
Mailing Address - Country:US
Mailing Address - Phone:301-288-1319
Mailing Address - Fax:552-301-3998
Practice Address - Street 1:19851 OBSERVATION DR STE 245
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4151
Practice Address - Country:US
Practice Address - Phone:301-288-1319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0097360207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology