Provider Demographics
NPI:1407654031
Name:ERAN KESSOUS MD PC
Entity type:Organization
Organization Name:ERAN KESSOUS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KESSOUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-754-0505
Mailing Address - Street 1:11120 NEW HAMPSHIRE AVE STE 411
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2620
Mailing Address - Country:US
Mailing Address - Phone:301-754-0505
Mailing Address - Fax:301-754-0509
Practice Address - Street 1:800 S FREDERICK AVE STE 110
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-4151
Practice Address - Country:US
Practice Address - Phone:301-754-0505
Practice Address - Fax:301-754-0509
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ERAN KESSOUS MD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies