Basic Information
| Provider Information | |||||||||
| NPI: | 1609072578 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PIROUZ | ||||||||
| FirstName: | BABAK | ||||||||
| MiddleName: | SALEHI | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 791372 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212791372 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016088375 | ||||||||
| FaxNumber: | 3016083979 | ||||||||
| Practice Location | |||||||||
| Address1: | 1648 HUNTINGDON PIKE | ||||||||
| Address2: | |||||||||
| City: | MEADOWBROOK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190468001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159473000 | ||||||||
| FaxNumber: | 2159383829 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2007 | ||||||||
| LastUpdateDate: | 11/10/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 0101255457 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD449461 | PA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 0101255457 | VA | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | D0066264 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 413264500 | 05 | MD | MEDICAID | 415096100 | 05 | MD | MEDICAID |