Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 15789 | MD |
N | 2251S0007X | Physical Therapist - Sports | 15789 | MD |
Y | 2251X0800X | Physical Therapist - Orthopedic | 15789 | MD |
NPI | 1508939448 |
---|---|
Provider Name | Massoud Talaie |
First Address | Rockville, MD 20852-3818 |
Second Address | Bethesda, MD 20817 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 12/02/2018 |