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General NPI Number Information
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NPI Number | 1871906156
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Entity Type | Individual
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Provider Name | DR. AMIR MANOOCHEHRI
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Gender | Male
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Dates
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Enumeration Date | 06/04/2014
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Last Update Date | 08/14/2017
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Provider Practice Location Address
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Address Line | 22 S GREENE ST RM N3E09
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City | BALTIMORE
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State | MD
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Zip | 21201-1544
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Country | US
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Telephone | 410-328-6110
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Fax |
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Provider Business Mailing Address
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Address Line | 5200 EASTERN AVE MFL WEST TOWER, 6TH FLOOR
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City | BALTIMORE
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State | MD
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Zip | 21224-2734
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Country | US
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Telephone | 240-994-1082
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Fax | 410-550-2972
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | D83740
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License Number State | MD
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