Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 043702 | DC |
N | 207XS0106X | Orthopaedic Hand Surgeon | 247012 | NY |
NPI | 1083811616 |
---|---|
Provider Name | Sam Moghtaderi |
First Address | Washington, DC 20037-1434 |
Second Address | Washington, DC 20037-1434 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 31/12/2015 |