Motamedi, Ata

Motamedi, Ata is an individual health care provider with primary practice located at 17904 Georgia Ave Suite # 304, Olney MD 20832-2239. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Motamedi, Ata can be contacted via phone (301) 924-2790.

Contact Information

Primary practice address
17904 Georgia Ave Suite # 304 Olney MD 20832-2239
Fax: (301) 924-1631
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X D0063999 Maryland

Profile Details

NPI number 1013904606
LBN Legal business name Motamedi, Ata
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2005
Last updated Dec 27th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013904606 NPPES
Maryland Other P00307411 RR MEDICARE
Maryland Other 132355 RR MEDICARE
Maryland Other 1194549 RR MEDICARE
Maryland Other 65112701 RR MEDICARE
Maryland MEDICAID 409839100 RR MEDICARE
Maryland Other 0033 RR MEDICARE
Maryland Other 5901543 RR MEDICARE

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