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Organization

PRO COVER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MOHAMMAD REZA GHANDI M.D. (SOLE MEMBER)
(301) 704-6040
Entity
Organization

Contact information

Practice address
4601 MARTIN LUTHER KING JR AVE SW, WASHINGTON, DC 20032-1131
(202) 574-5700
Mailing address
16100 NURSERY LN, GAITHERSBURG, MD 20878-2211
(301) 704-6040

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
MD035078
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
414510100
MD
Enumeration date
11/23/2010
Last updated
10/10/2016
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