Pro Cover LLC

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

MD035078 Issued in DC

Legal business name

PRO COVER LLC

Practice address

4601 Martin Luther King Jr Ave SW
Washington, DC 20032-1131

Phone

(202) 574-5700

NPI assigned

Nov 23, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mohammad Reza Ghandi, M.D.

Title

Sole Member

Phone

(301) 704-6040

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476057600000",
    "number": "1952603987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16100 NURSERY LN",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208782211",
            "telephone_number": "301-704-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 MARTIN LUTHER KING JR AVE SW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200321131",
            "telephone_number": "202-574-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO COVER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-23",
        "last_updated": "2016-10-10",
        "status": "A",
        "authorized_official_last_name": "GHANDI",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "REZA",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "301-704-6040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "DC",
            "license": "MD035078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "414510100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Critical Care Medicine (Internal Medicine) Physician in Washington, DC
• Providers in Washington, DC by specialty
• Critical Care Medicine (Internal Medicine) Physician in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.