Individual
MISAGH MICHAEL DOROST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
301 RUSSELL AVE, GAITHERSBURG, MD 20877-2807
(301) 216-4248
Mailing address
21226 VIRGINIA PINE TER, GERMANTOWN, MD 20876-4382
(240) 388-5240
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
08107
MD
Other
Enumeration date
09/26/2017
Last updated
03/07/2019
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