Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 01124 | NC |
NPI | 1083695043 |
---|---|
Provider Name | Dr. Amir H Marashi |
First Address | Charlotte, NC 28210-8911 |
Second Address | Charlotte, NC 28210-8911 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2005 |
Last Update Date | 08/07/2007 |