Provider Demographics
NPI:1740245802
Name:SOTOODEHFAR, RAHIM (MD)
Entity Type:Individual
Prefix:
First Name:RAHIM
Middle Name:
Last Name:SOTOODEHFAR
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 1:9104 BABCOCK BLVD
Mailing Address - Street 2:SUITE 5112
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5818
Mailing Address - Country:US
Mailing Address - Phone:412-366-4402
Mailing Address - Fax:412-366-1633
Practice Address - Street 1:9104 BABCOCK BLVD
Practice Address - Street 2:SUITE 5112
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5818
Practice Address - Country:US
Practice Address - Phone:412-366-4402
Practice Address - Fax:412-366-1633
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036108L207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA149455Medicare ID - Type Unspecified
PAC31939Medicare UPIN