Provider Demographics
NPI:1972509347
Name:RADFAR, ROUHANGIZ HOORAZAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROUHANGIZ
Middle Name:HOORAZAR
Last Name:RADFAR
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 1:730 BROOKLINE BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15226-2102
Mailing Address - Country:US
Mailing Address - Phone:412-207-8874
Mailing Address - Fax:
Practice Address - Street 1:730 BROOKLINE BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15226-2102
Practice Address - Country:US
Practice Address - Phone:412-207-8847
Practice Address - Fax:412-892-9404
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD018445E207RE0101X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10820704103Medicaid
PA051510Medicare ID - Type Unspecified
PA10820704103Medicaid