Provider Demographics
NPI:1922567288
Name:CHAR, SARA KHOSROWJERDI (MD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:KHOSROWJERDI
Last Name:CHAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:KHOSROWJERDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:55 FRUIT STREET
Mailing Address - Street 2:GRB 7-730
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114
Mailing Address - Country:US
Mailing Address - Phone:617-724-9557
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT STREET
Practice Address - Street 2:GRB 7-730
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-724-9557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-17
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1013808207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine