Provider Demographics
NPI:1316142227
Name:OGHOLIKHAN, MANA (MD)
Entity type:Individual
Prefix:DR
First Name:MANA
Middle Name:
Last Name:OGHOLIKHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 MASSACHUSETTS AVE NW APT 1313
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-5133
Mailing Address - Country:US
Mailing Address - Phone:202-276-8403
Mailing Address - Fax:
Practice Address - Street 1:8401 CONNECTICUT AVE STE 210
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-5837
Practice Address - Country:US
Practice Address - Phone:240-482-2555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0066213207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology