Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 28613 | OK |
N | 111NI0900X | Internist | 28613 | OK |
Y | 207RH0003X | Hematology & Oncology | DR.0059632 | CO |
NPI | 1023303096 |
---|---|
Provider Name | Hossein Maymani |
First Address | Longmont, CO 80501-3180 |
Second Address | Longmont, CO 80501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2011 |
Last Update Date | 29/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9000158806 | (05) | CO |