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Individual

DR. AMIRALI MODIR SHANECHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
600 N WOLFE ST, BALTIMORE, MD 21287-0005
(410) 955-5000
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6423

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
309048
NY
2085R0202X
Diagnostic Radiology Physician
Primary
D86994
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D86994
LICENSE
MD
Enumeration date
05/13/2013
Last updated
07/22/2021
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