Healthcare Provider Details

I. General information

NPI: 1023660677
Provider Name (Legal Business Name): MOHAMMAD-EHSAN OWRANGI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2019
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 PINE ST STE 202
MONTGOMERY AL
36106-1154
US

IV. Provider business mailing address

320 E NORTH AVE STE 133B
PITTSBURGH PA
15212-4756
US

V. Phone/Fax

Practice location:
  • Phone: 412-359-3166
  • Fax: 412-359-8164
Mailing address:
  • Phone: 412-359-3166
  • Fax: 412-359-8164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD.48565
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: