Individual ProviderAmirali Modir ShanechiRadiologyAllopathic & Osteopathic PhysiciansPractice Address600 N Wolfe St, Baltimore, MD 21287-0005(410) 955-5000(410) 933-6423PECOS EnrollmentBased on the most recent information from CMS, provider Amirali Modir Shanechi is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1184060576Provider TypeIndividualFull NameModir Shanechi, AmiraliTitleDr.CredentialM.D.GenderMaleSole ProprietorNoEnumeration Date5/13/2013Last Updated7/22/2021Contact InformationPractice LocationPractice Address600 N Wolfe St, Baltimore, MD 21287-0005Phone(410) 955-5000FaxUnlisted FaxMailing LocationMailing Address6201 Greenleigh Ave, Middle River, MD 21220-2004Phone(410) 933-6423FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode2085R0202XPrimaryDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicenseD86994MarylandCode2085R0202XDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicense309048New YorkProvider IdentifiersIDDescriptionIssuerIDD86994DescriptionOtherIssuerLICENSEMaryland