Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2012038837 | MO |
N | 111NI0900X | Internist | 2012038837 | MO |
N | 207R00000X | Internist | BP10027676 | TX |
N | 111NI0900X | Internist | BP10027676 | TX |
Y | 207RC0200X | Critical Care Medicine | 2012038837 | MO |
NPI | 1003090952 |
---|---|
Provider Name | Majed Safiyeh |
First Address | Joplin, MO 64803-3810 |
Second Address | Joplin, MO 64804-3503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2007 |
Last Update Date | 20/04/2017 |