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General NPI Number Information
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NPI Number | 1316142227
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Entity Type | Individual
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Provider Name | MANA OGHOLIKHAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8401 CONNECTICUT AVE STE 210
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City | CHEVY CHASE
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State | MD
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Zip | 20815-5837
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Country | US
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Telephone | 240-482-2555
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 MASSACHUSETTS AVE NW APT 1313
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City | WASHINGTON
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State | DC
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Zip | 20016-5133
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Country | US
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Telephone | 202-276-8403
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Fax |
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | D0066213
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License Number State | MD
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