Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 35 07 8436 2 | OH |
NPI | 1043208309 |
---|---|
Provider Name | Mehrdad Zarrinmakan |
First Address | Warren, OH 44484-2352 |
Second Address | Warren, OH 44484-2352 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2005 |
Last Update Date | 24/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2185746 | (05) | OH |
300059609 00 | BWC (01) | OH |
G58264 | (02) |