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NPI Code Detail

MEDICARE: ERAN KESSOUS M.D.

MEDICARE:   ERAN  KESSOUS  M.D.
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
1207QS0010XSports Medicine (Family Medicine) PhysicianD0066523MD

General Provider Information

NPI Number : 1821033358
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERAN KESSOUS M.D.
Provider Business Mailing Address
First Line : 11120 NEW HAMPSHIRE AVE
Second Line : SUITE 411
City : SILVER SPRING
State : MD
Zip : 20904-2633
Country : US
Telephone Number : 301-754-0505
Fax Number : 301-754-0509
Provider Business Practice Location Address
First Line : 11120 NEW HAMPSHIRE AVE
Second Line : SUITE 411
City : SILVER SPRING
State : MD
Zip : 20904-2633
Country : US
Telephone Number : 301-754-0505
Fax Number : 301-754-0509
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2006
Last Update Date : 10/26/2012

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Directions to “ ERAN KESSOUS M.D.” Practice Location

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