Provider Demographics
NPI:1215152343
Name:SOHRABI, FARROKH (MD)
Entity type:Individual
Prefix:DR
First Name:FARROKH
Middle Name:
Last Name:SOHRABI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64916
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4916
Mailing Address - Country:US
Mailing Address - Phone:443-481-6482
Mailing Address - Fax:443-481-6515
Practice Address - Street 1:2001 MEDICAL PKWY
Practice Address - Street 2:ACUTE CARE PAVILION
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3280
Practice Address - Country:US
Practice Address - Phone:443-481-1000
Practice Address - Fax:443-481-6515
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0065230207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4126581Medicaid
91350001OtherCAREFIRST
0044OtherCAREFIRST
1613665OtherAETNA HMO
145724700OtherFEDERAL WOKMAN;S COMP
325666OtherAMERIGROUP
7803968OtherAETNA PPO
91350001OtherCAREFIRST
P00917258Medicare PIN
145724700OtherFEDERAL WOKMAN;S COMP