Provider Demographics
NPI:1205903259
Name:PERINATAL ASSOCIATES LLC
Entity type:Organization
Organization Name:PERINATAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT AGENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:ANTONIOS
Authorized Official - Last Name:KHOUZAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-849-2568
Mailing Address - Street 1:6565 N CHARLES ST
Mailing Address - Street 2:SUITE 406
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6800
Mailing Address - Country:US
Mailing Address - Phone:443-849-2568
Mailing Address - Fax:410-321-7344
Practice Address - Street 1:6565 N CHARLES ST
Practice Address - Street 2:SUITE 406
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-6800
Practice Address - Country:US
Practice Address - Phone:443-849-2568
Practice Address - Fax:410-321-7344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty