Provider Demographics
NPI:1164538583
Name:MOSTOUFIZADEH, MAHPAREH G (MD)
Entity Type:Individual
Prefix:
First Name:MAHPAREH
Middle Name:G
Last Name:MOSTOUFIZADEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 VINIAL ST
Mailing Address - Street 2:SUITE B407A
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-5151
Mailing Address - Country:US
Mailing Address - Phone:412-323-4402
Mailing Address - Fax:412-323-4418
Practice Address - Street 1:565 COAL VALLEY RD
Practice Address - Street 2:
Practice Address - City:CLAIRTON
Practice Address - State:PA
Practice Address - Zip Code:15025-3703
Practice Address - Country:US
Practice Address - Phone:412-469-5728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038191E207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA66531OtherMEDPLUS
PA220003659OtherRR MEDICARE
PA444133OtherHIGHMARK/BLUE SHIELD
PA0010893060010Medicaid
PA101117OtherUPMC HEALTH PLAN
PA101117OtherUPMC HEALTH PLAN
PA444133Medicare ID - Type Unspecified