Individual
DR. AHMAD REZA HOSSANI-MADANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1221 MERCANTILE LN, KAISER PERMANENTE LARGO MEDICAL CENTER, LARGO, MD 20774-5374
(301) 618-5500
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
D76642
MD
Other
Enumeration date
06/09/2008
Last updated
06/01/2021
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