Provider Demographics
NPI:1891775706
Name:GHASEMIAN, SEYED (MD)
Entity Type:Individual
Prefix:DR
First Name:SEYED
Middle Name:
Last Name:GHASEMIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3206 PAULINE DR
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-3922
Mailing Address - Country:US
Mailing Address - Phone:301-656-7478
Mailing Address - Fax:
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:DEPT. OF UROLOGY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2976
Practice Address - Country:US
Practice Address - Phone:301-209-5612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD31467208800000X, 204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC025730700Medicaid
DC525104400Medicaid
DC007504101Medicaid
DC003642U47Medicare ID - Type UnspecifiedTRAILBLAZER
DC525104400Medicaid
DCG98585Medicare UPIN