Organization
M NEMATI MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MASSOUD NEMATI (PRESIDENT)
(301) 899-2100
Entity
Organization
Contact information
Practice address
3611 BRANCH AVE, TEMPLE HILLS, MD 20748-1242
(301) 899-2100
Mailing address
9929 BENTCROSS DR, POTOMAC, MD 20854-4741
(301) 899-2100
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
D0022305
MD
207R00000X
Internal Medicine Physician
MD6873
DC
207RC0000X
Cardiovascular Disease Physician
Primary
D0022305
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036044400
—
DC
01
—
0468
CAREFIRST BLUECROSS
DC
05
—
972231900
—
MD
01
—
F629MA
CAREFIRST BLUECROSS
MD
Enumeration date
08/15/2006
Last updated
04/21/2010
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