Provider Demographics
NPI:1841430030
Name:ASSARPOUR, AZADEH (MD)
Entity Type:Individual
Prefix:
First Name:AZADEH
Middle Name:
Last Name:ASSARPOUR
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 1:268 TRAPELO RD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-1849
Mailing Address - Country:US
Mailing Address - Phone:617-484-0235
Mailing Address - Fax:617-484-0238
Practice Address - Street 1:268 TRAPELO RD
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-1849
Practice Address - Country:US
Practice Address - Phone:617-484-0235
Practice Address - Fax:617-484-0238
Is Sole Proprietor?:No
Enumeration Date:2009-02-27
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA249995207R00000X
MA238569207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine