Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | MD017873E | PA |
N | 2080P0205X | Pediatric Endocrinologist | MD017837E | PA |
NPI | 1922004019 |
---|---|
Provider Name | Dr. Nezam Radfar |
First Address | Pittsburgh, PA 15226-2102 |
Second Address | Pittsburgh, PA 15226-2102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 30/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0006181060001 | (05) | PA |
C29108 | (02) | PA |