Provider Demographics
NPI:1770738932
Name:JOMEHDOKHT, SAEEDEH (MD)
Entity type:Individual
Prefix:
First Name:SAEEDEH
Middle Name:
Last Name:JOMEHDOKHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18041 FENCE POST CT
Mailing Address - Street 2:GAITHERSBURG
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-3795
Mailing Address - Country:US
Mailing Address - Phone:301-330-3194
Mailing Address - Fax:
Practice Address - Street 1:18041 FENCE POST CT
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-3795
Practice Address - Country:US
Practice Address - Phone:301-330-3194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101252211207Q00000X
MDD0075337207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine