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Individual

AMIR HOSSAIN KHODABANDELOU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6 SAINT ANDREWS CROSSOVER, SEVERNA PARK, MD 21146-2403
(443) 524-2737
Mailing address
6 SAINT ANDREWS CROSSOVER, SEVERNA PARK, MD 21146-2403

Taxonomy

Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
C0003440
MD
363A00000X
Physician Assistant
Primary
C03440
MD

Other

Enumeration date
04/21/2010
Last updated
07/10/2024
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