Healthcare Provider Details

I. General information

NPI: 1316881014
Provider Name (Legal Business Name): GOHARI HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9063 SHADY GROVE CT
GAITHERSBURG MD
20877-1301
US

IV. Provider business mailing address

9063 SHADY GROVE CT
GAITHERSBURG MD
20877-1301
US

V. Phone/Fax

Practice location:
  • Phone: 301-857-1603
  • Fax: 301-325-1561
Mailing address:
  • Phone: 301-857-1603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: JANAN ANISSA GOHARI
Title or Position: OWNER
Credential: MD
Phone: 301-857-1603