Provider Demographics
NPI:1578621587
Name:HAMRAHIAN, SEYED MEHRDAD (MD)
Entity Type:Individual
Prefix:DR
First Name:SEYED
Middle Name:MEHRDAD
Last Name:HAMRAHIAN
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 1:833 CHESTNUT ST
Mailing Address - Street 2:7TH FLOOR, STE. 700
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4414
Mailing Address - Country:US
Mailing Address - Phone:215-503-3000
Mailing Address - Fax:215-503-4099
Practice Address - Street 1:833 CHESTNUT ST
Practice Address - Street 2:7TH FLOOR, SUITE 700
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4414
Practice Address - Country:US
Practice Address - Phone:201-503-3000
Practice Address - Fax:215-503-4099
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS21251207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0372994Medicaid
MS05189525Medicaid
PA1028681100001Medicaid
LA1457523Medicaid
MS30293I0979Medicare PIN
PA316229PAGMedicare PIN
MS05189525Medicaid
MS302I392791Medicare PIN