Provider Demographics
NPI:1205153947
Name:HERATI, AMIN SEDAGHAT (MD)
Entity type:Individual
Prefix:
First Name:AMIN
Middle Name:SEDAGHAT
Last Name:HERATI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:9910 FRANKLIN SQUARE DR STE 2110
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4902
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:410-933-1390
Practice Address - Street 1:4940 EASTERN AVE BLDG 3
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2735
Practice Address - Country:US
Practice Address - Phone:410-550-7742
Practice Address - Fax:410-550-3341
Is Sole Proprietor?:No
Enumeration Date:2010-04-20
Last Update Date:2017-10-09
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Provider Licenses
StateLicense IDTaxonomies
MDD83492208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology