Mohammad M Mousavian
Oral & Maxillofacial Surgeon
55 Fruit St Bldg Suite230
Boston
, Massachusetts 02114-2621
Mohammad M Mousavian
Oral & Maxillofacial Surgeon
55 Fruit St Bldg Suite230
Boston
, Massachusetts 02114-2621
(617) 726-2741
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About
Features
Specialties
- Oral & Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Mohammad M Mousavian
- 55 Fruit St Bldg Suite230
- Boston, MA
- Zip : 02114-2621
- Phone : (617) 726-2741
Second Address
- Mohammad M Mousavian
- 55 Fruit St Bldg Suite230
- Boston, MA
- Zip : 02114-2621
- Phone : (617) 726-2741
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Is Mohammad M Mousavian a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 204E00000X | Oral & Maxillofacial Surgeon | DL14005 | MA |
| Y | 204E00000X | Oral & Maxillofacial Surgeon | DN1858982 | MA |
National Provider Identifier
| NPI | 1174182414 |
|---|---|
| Provider Name | Mohammad M Mousavian |
| First Address | Boston, MA 02114-2621 |
| Second Address | Boston, MA 02114-2621 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/06/2019 |
| Last Update Date | 01/07/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.