Healthcare Provider Details
I. General information
NPI: 1992192108
Provider Name (Legal Business Name): VAHID KHAJOEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/25/2015
Last Update Date: 07/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 HOSPITAL RD
PRINCE FREDERICK MD
20678-4017
US
IV. Provider business mailing address
7250 PARKWAY DR STE 500
HANOVER MD
21076-1343
US
V. Phone/Fax
- Phone: 410-535-4000
- Fax:
- Phone: 443-949-0814
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | D0078625 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: