Provider Demographics
NPI:1578556429
Name:EMAMI-AHARI, ABDOLHOSSEIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDOLHOSSEIN
Middle Name:
Last Name:EMAMI-AHARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ABDI
Other - Middle Name:
Other - Last Name:AHARI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:250 S CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-2926
Mailing Address - Country:US
Mailing Address - Phone:641-494-5400
Mailing Address - Fax:641-494-5403
Practice Address - Street 1:250 S CRESCENT DR
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2926
Practice Address - Country:US
Practice Address - Phone:641-494-5260
Practice Address - Fax:641-494-5267
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA34902208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0297911Medicaid
IAH83366Medicare UPIN
IA0297911Medicaid