Provider Demographics
NPI:1700064607
Name:E MASOUD POUR MD PA
Entity Type:Organization
Organization Name:E MASOUD POUR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ESMAIL
Authorized Official - Middle Name:MASOUD
Authorized Official - Last Name:POUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-220-3000
Mailing Address - Street 1:7211 HANOVER PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770
Mailing Address - Country:US
Mailing Address - Phone:301-220-3000
Mailing Address - Fax:301-220-3005
Practice Address - Street 1:7211 HANOVER PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770
Practice Address - Country:US
Practice Address - Phone:301-220-3000
Practice Address - Fax:301-220-3005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G01382Medicare PIN
D09448Medicare UPIN