Provider Demographics
NPI:1649255670
Name:MOHABER, ERIK (OD)
Entity type:Individual
Prefix:DR
First Name:ERIK
Middle Name:
Last Name:MOHABER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WISCONSIN CIR STE 230
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-7005
Mailing Address - Country:US
Mailing Address - Phone:301-215-7100
Mailing Address - Fax:301-215-4144
Practice Address - Street 1:4600 N PARK AVE
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4518
Practice Address - Country:US
Practice Address - Phone:301-215-7100
Practice Address - Fax:301-215-4144
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA2433152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ073243DKXMedicare ID - Type Unspecified
NJU96851Medicare UPIN