Provider Demographics
NPI:1992882336
Name:MOSHEDI, EMIL PAYMAN (MD)
Entity type:Individual
Prefix:
First Name:EMIL
Middle Name:PAYMAN
Last Name:MOSHEDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9841 GREENBELT RD
Mailing Address - Street 2:STE 102
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-6216
Mailing Address - Country:US
Mailing Address - Phone:301-552-5000
Mailing Address - Fax:301-552-5003
Practice Address - Street 1:9841 GREENBELT RD
Practice Address - Street 2:SUITE 102
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-6269
Practice Address - Country:US
Practice Address - Phone:301-552-5000
Practice Address - Fax:301-552-5003
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0042747207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD19962OtherJOHNS HOPKINS HEALTHCARE
MD593010300Medicaid
MD255643OtherMAMSI/ALLIANCE
MD3530 0001OtherCAREFIRST
MD180031454OtherRAILROAD MEDICARE
MD7518228004OtherCIGNA
MD1023658OtherAETNA
MD54695701OtherBLUE SHIELD OF MARYLAND
MD88630OtherAMERIGROUP
740780Medicare ID - Type Unspecified
G44813Medicare UPIN