Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 238379 | MA |
NPI | 1083640825 |
---|---|
Provider Name | Dr. Adel Bozorgzadeh |
First Address | Hopkinton, MA 01748-2581 |
Second Address | Hopkinton, MA 01748-2581 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 10/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110081143A | (05) | MA |
H00566 | (02) |