Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | P20359 | MD |
Y | 111NI0900X | Internist | P20359 | MD |
NPI | 1003075243 |
---|---|
Provider Name | Masoud Kalantar |
First Address | Lexington, KY 40509-2031 |
Second Address | Cheverly, MD 20785-1189 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2008 |
Last Update Date | 03/06/2008 |