Provider Demographics
NPI:1134174980
Name:BATEN, MOHAMMAD O (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:O
Last Name:BATEN
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 1:13315 DEERBROOK DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-6368
Mailing Address - Country:US
Mailing Address - Phone:301-762-9046
Mailing Address - Fax:
Practice Address - Street 1:1901 RESEARCH BLVD
Practice Address - Street 2:350
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3164
Practice Address - Country:US
Practice Address - Phone:301-838-9606
Practice Address - Fax:301-838-9029
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD45629207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
601285800OtherFECA
MD407012700Medicaid
MDG01485F03Medicare ID - Type UnspecifiedMD MEDICARE GROUP G04185
F79475Medicare UPIN
MD839M465FMedicare ID - Type UnspecifiedMD MEDICARE GROUP 839M