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General NPI Number Information
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NPI Number | 1083811616
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Entity Type | Individual
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Provider Name | SAM MOGHTADERI M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 12/31/2015
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Provider Practice Location Address
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Address Line | 2300 M ST NW 5TH FLOOR
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City | WASHINGTON
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State | DC
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Zip | 20037-1434
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Country | US
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Telephone | 202-741-3311
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Fax | 202-741-3313
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Provider Business Mailing Address
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Address Line | 2300 M ST NW 5TH FLOOR
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City | WASHINGTON
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State | DC
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Zip | 20037-1434
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Country | US
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Telephone | 202-741-3311
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Fax | 202-741-3313
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 247012
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 043702
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License Number State | DC
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