Healthcare Provider Details

I. General information

NPI: 1780742833
Provider Name (Legal Business Name): MOHAMMAD H ZAMANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 04/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 FONTANA LN STE 107 109
BALTO MD
21237
US

IV. Provider business mailing address

17 FONTANA LN STE 107 109
BALTO MD
21237
US

V. Phone/Fax

Practice location:
  • Phone: 410-574-2630
  • Fax: 410-686-2894
Mailing address:
  • Phone: 410-574-2630
  • Fax: 410-686-2894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberD0020285
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: