MEDICARE: MITRA HASHEMI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	D75810	MD

General Provider Information

NPI Number	:	1225354905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MITRA HASHEMI MD

Provider Business Mailing Address
First Line	:	8807 COLESVILLE RD
Second Line	:	SECOND FLOOR
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-4346
Country	:	US
Telephone Number	:	301-608-3833
Fax Number	:

Provider Business Practice Location Address
First Line	:	8807 COLESVILLE RD
Second Line	:	SECOND FLOOR
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-4346
Country	:	US
Telephone Number	:	301-608-3833
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2010
Last Update Date	:	02/06/2015

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