Individual
POOYA HEIRATY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(667) 214-1616
(410) 328-1674
Mailing address
1 MEDICAL CENTER DR, MORGANTOWN, WV 26506-1200
(304) 598-4800
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
26455
WV
207L00000X
Anesthesiology Physician
Primary
D84533
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2012
Last updated
04/08/2022
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