Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 0401412408 | VA |
NPI | 1023340189 |
---|---|
Provider Name | Dr. Pedram Yaghmai |
First Address | Pittsburgh, PA 15214-1468 |
Second Address | Lansdowne, VA 20176-8263 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2010 |
Last Update Date | 31/01/2010 |