Provider Demographics
NPI:1295444677
Name:MOHAJERI, SEPIDEH (MD)
Entity type:Individual
Prefix:DR
First Name:SEPIDEH
Middle Name:
Last Name:MOHAJERI
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 1:1200 MAIN STREET WEST MCMASTER CHILDREN'S HOSPITAL; DEP
Mailing Address - Street 2:OFFICE: 4E16; LINDA MCLEAN (CAROL DOW/SEPIDEH MOHAJERI)
Mailing Address - City:HAMILTON
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L8N 3Z5
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 MAIN STREET WEST
Practice Address - Street 2:MCMASTER CHILDREN'S HOSPITAL; DEPARTMENT OF SURGERY
Practice Address - City:HAMILTON
Practice Address - State:ONTARIO
Practice Address - Zip Code:L8N 3Z5
Practice Address - Country:CA
Practice Address - Phone:905-522-1155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-15
Last Update Date:2023-10-03
Deactivation Date:2023-09-28
Deactivation Code:
Reactivation Date:2023-10-03
Provider Licenses
StateLicense IDTaxonomies
ZZ115821207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology