Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD210001436 | DC |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | S4873 | TX |
N | 207YS0123X | Facial Plastic Surgeon | MD210001436 | DC |
NPI | 1609260124 |
---|---|
Provider Name | Dr. Tom Shokri |
First Address | Washington, DC 20037-1434 |
Second Address | Washington, DC 20037-1434 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2015 |
Last Update Date | 09/08/2021 |