Organization
ATA O MOSHYEDI MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ATA O MOSHYEDI MD (PRESIDENT)
(301) 805-4586
Entity
Organization
Contact information
Practice address
7305 HANOVER PKWY, SUITE A, GREENBELT, MD 20770-2030
(301) 982-7900
Mailing address
7305 HANOVER PKWY, SUITE A, GREENBELT, MD 20770-2030
(301) 982-7900
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
D0009179
MD
207RG0100X
Gastroenterology Physician
Primary
D0046093
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017961200
—
MD
01
—
110083708
RAILROAD MEDICARE
MD
01
—
112507442
RAILROAD MEDICARE
MD
01
—
4054276
AETNA
MD
01
—
4566293
AETNA
MD
01
—
4768 0001
CAREFIRST BLUE CROSS BLUE SHIELD
MD
01
—
4768 0002
CAREFIRST BLUE CROSS BLUE SHIELD
MD
01
—
6239AO
BLUE SHIELD OF MARYLAND
MD
01
—
72489
AMERIGROUP
MD
Enumeration date
06/13/2008
Last updated
06/13/2008
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