Individual
DR. MASSOUD NEMATI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3611 BRANCH AVE, TEMPLE HILLS, MD 20748-1242
(301) 899-2100
(301) 899-3309
Mailing address
9929 BENTCROSS DR, POTOMAC, MD 20854-4741
(301) 899-2100
(301) 899-3309
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD6873
DC
207RC0000X
Cardiovascular Disease Physician
Primary
D0022305
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023061700
—
DC
01
—
0468
BLUESHEILD
DC
01
—
34412701
BLUESHEILD
MD
01
—
521202860
TAX ID
MD
05
—
972231900
—
MD
Enumeration date
08/19/2006
Last updated
04/23/2010
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