Provider Demographics
NPI:1417530502
Name:HAMEDI, BAHAREH (MD)
Entity Type:Individual
Prefix:
First Name:BAHAREH
Middle Name:
Last Name:HAMEDI
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 1:200 1ST STREET SW MAYO CLINIC
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55905
Mailing Address - Country:US
Mailing Address - Phone:507-266-3262
Mailing Address - Fax:507-266-7953
Practice Address - Street 1:200 1ST STREET SW MAYO CLINIC
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55905
Practice Address - Country:US
Practice Address - Phone:507-266-3262
Practice Address - Fax:507-266-7953
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2022-08-08
Deactivation Date:2022-04-28
Deactivation Code:
Reactivation Date:2022-07-01
Provider Licenses
StateLicense IDTaxonomies
MN71845207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology