Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 284019 | MA |
NPI | 1073976932 |
---|---|
Provider Name | Amir Mehdizadeh |
First Address | Worcester, MA 01605-2903 |
Second Address | Worcester, MA 01604-5465 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2016 |
Last Update Date | 03/09/2020 |