Healthcare Provider Details

I. General information

NPI: 1184588063
Provider Name (Legal Business Name): WEDGE HEALTH MEDICAL GROUP, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10811 BARN WOOD LN
POTOMAC MD
20854-1329
US

IV. Provider business mailing address

2261 MARKET ST STE 85353
SAN FRANCISCO CA
94114-1612
US

V. Phone/Fax

Practice location:
  • Phone: 301-706-4461
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEX MOHSENI
Title or Position: PRESIDENT
Credential: MD
Phone: 301-706-4461