Individual ProviderOmid KhalilzadehRadiologyAllopathic & Osteopathic PhysiciansPractice Address600 N Wolfe St, Baltimore, MD 21287-0005(410) 955-6369(410) 933-6423PECOS EnrollmentBased on the most recent information from CMS, provider Omid Khalilzadeh 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 6 days ago.Profile DetailsProvider ID1538571856Provider TypeIndividualFull NameKhalilzadeh, OmidCredentialMD, MPHGenderMaleSole ProprietorNoEnumeration Date5/21/2014Last Updated11/2/2022Contact InformationPractice LocationPractice Address600 N Wolfe St, Baltimore, MD 21287-0005Phone(410) 955-6369Fax(410) 502-3714Mailing LocationMailing Address6201 Greenleigh Ave, Middle River, MD 21220-2004Phone(410) 933-6423FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode2085R0202XPrimaryDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicenseD89474MarylandCode2085R0202XDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicenseL-259657Massachusetts