Provider Demographics
NPI:1578786802
Name:MOJDEHI, ROSA (MDCM)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:
Last Name:MOJDEHI
Suffix:
Gender:F
Credentials:MDCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BAKER RD
Mailing Address - Street 2:
Mailing Address - City:CAPE ELIZABETH
Mailing Address - State:ME
Mailing Address - Zip Code:04107-1328
Mailing Address - Country:US
Mailing Address - Phone:802-735-5743
Mailing Address - Fax:
Practice Address - Street 1:195 FORE RIVER PARKWAY
Practice Address - Street 2:ALL ABOUT WOMEN
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102
Practice Address - Country:US
Practice Address - Phone:207-553-6920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH20026207V00000X
MEMD19735207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology