Provider Demographics
NPI:1053379800
Name:BATOULI, AMIR R (MD)
Entity type:Individual
Prefix:
First Name:AMIR
Middle Name:R
Last Name:BATOULI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:410-500-4266
Practice Address - Street 1:8600 OLD GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1422
Practice Address - Country:US
Practice Address - Phone:301-896-3497
Practice Address - Fax:301-896-7399
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD428683174400000X
DCMD0432712085R0202X
VA0102379872085R0202X
MDD614892085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAI09148Medicare UPIN