Provider Demographics
NPI:1043208309
Name:ZARRINMAKAN, MEHRDAD (MD)
Entity Type:Individual
Prefix:
First Name:MEHRDAD
Middle Name:
Last Name:ZARRINMAKAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8952 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2352
Mailing Address - Country:US
Mailing Address - Phone:330-856-4366
Mailing Address - Fax:330-856-9656
Practice Address - Street 1:8952 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2352
Practice Address - Country:US
Practice Address - Phone:330-856-4366
Practice Address - Fax:330-856-9656
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 07 8436 2208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH300059609 00OtherBWC
OH2185746Medicaid
G58264Medicare UPIN
OH300059609 00OtherBWC