Provider Demographics
NPI:1053630285
Name:ADHAM, KASRA (MD)
Entity type:Individual
Prefix:DR
First Name:KASRA
Middle Name:
Last Name:ADHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:125 POTOMAC PSGE STE 250
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-1580
Mailing Address - Country:US
Mailing Address - Phone:240-737-0085
Mailing Address - Fax:202-296-0301
Practice Address - Street 1:125 POTOMAC PSGE STE 250
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-1580
Practice Address - Country:US
Practice Address - Phone:240-737-0085
Practice Address - Fax:202-296-0301
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-27
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD045930207RG0100X
MDD0083232207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology