Provider Demographics
NPI:1790054518
Name:KATEBI KASHI, PAYAM (MD, PHD)
Entity type:Individual
Prefix:
First Name:PAYAM
Middle Name:
Last Name:KATEBI KASHI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:PAYAM
Other - Middle Name:
Other - Last Name:KATEBI KASHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:600 N. WOLFE ST.
Mailing Address - Street 2:PHIPPS 281
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-4577
Mailing Address - Country:US
Mailing Address - Phone:410-955-8240
Mailing Address - Fax:
Practice Address - Street 1:600 N. WOLFE ST.
Practice Address - Street 2:PHIPPS 281
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-2128
Practice Address - Country:US
Practice Address - Phone:410-955-8240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-22
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3270390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program