Provider Demographics
NPI:1528111564
Name:KHERADMAND, AMIR (MD)
Entity type:Individual
Prefix:DR
First Name:AMIR
Middle Name:
Last Name:KHERADMAND
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:THE JOHNS HOPKINS HOSPITAL
Mailing Address - Street 2:PATH 2-210, 600 N.WOLFE STREET
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0001
Mailing Address - Country:US
Mailing Address - Phone:410-955-3319
Mailing Address - Fax:410-614-1746
Practice Address - Street 1:THE JOHNS HOPKINS HOSPITAL
Practice Address - Street 2:PATH 2-210, 600 N.WOLFE STREET
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0001
Practice Address - Country:US
Practice Address - Phone:410-955-3319
Practice Address - Fax:410-614-1746
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4860012084N0400X
MDD00714752084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
16276153OtherCAQH