Provider Demographics
NPI:1871606889
Name:PIRMOHAMED, MOEZ L (MD)
Entity type:Individual
Prefix:DR
First Name:MOEZ
Middle Name:L
Last Name:PIRMOHAMED
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:POST OFFICE ROAD
Mailing Address - Street 2:SUITE 7B
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602
Mailing Address - Country:US
Mailing Address - Phone:301-843-0552
Mailing Address - Fax:301-843-4917
Practice Address - Street 1:POST OFFICE ROAD
Practice Address - Street 2:SUITE 7B
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602
Practice Address - Country:US
Practice Address - Phone:301-843-0552
Practice Address - Fax:301-843-4917
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD30246207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD027411OtherPRIORITY PARTNERS
MD63640001OtherBCBS
MD408808500Medicaid
MD6919OtherBSBC
MDP00281256Medicare PIN
MD027411OtherPRIORITY PARTNERS
MD408808500Medicaid
MD119P320GMedicare PIN