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Individual

KOUROSH MASTALI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7501 OSLER DR, THIRD FLOOR, TOWSON, MD 21204-7733
(410) 583-1170
(410) 583-1267
Mailing address
1838 GREENE TREE RD, SUITE 150, BALTIMORE, MD 21208-6391
(410) 602-9262
(410) 602-9276

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
D0064509
MD
207RI0011X
Interventional Cardiology Physician
Primary
D0064509
MD

Other

Enumeration date
06/08/2006
Last updated
01/10/2022
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