Provider Demographics
NPI:1902861347
Name:BEHI, FEREIDOUN (MD)
Entity Type:Individual
Prefix:MR
First Name:FEREIDOUN
Middle Name:
Last Name:BEHI
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 1:480 GLESSNER AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903
Mailing Address - Country:US
Mailing Address - Phone:419-522-3372
Mailing Address - Fax:419-526-1303
Practice Address - Street 1:480 GLESSNER AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903
Practice Address - Country:US
Practice Address - Phone:419-522-3372
Practice Address - Fax:419-526-1303
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
OH35038896B207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0354316Medicaid
OH0354316Medicaid
OH0427202Medicare ID - Type Unspecified