Provider Demographics
NPI:1306841275
Name:MOVASSAGHI, KIUMARS (MEDICAL DOCTOR)
Entity Type:Individual
Prefix:DR
First Name:KIUMARS
Middle Name:
Last Name:MOVASSAGHI
Suffix:
Gender:M
Credentials:MEDICAL DOCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 S GARDEN WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-8177
Mailing Address - Country:US
Mailing Address - Phone:541-686-8700
Mailing Address - Fax:541-686-9004
Practice Address - Street 1:330 S GARDEN WAY STE 100
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-8177
Practice Address - Country:US
Practice Address - Phone:541-686-8700
Practice Address - Fax:541-686-9004
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist