Provider Demographics
NPI:1457603284
Name:HAMIDI, JAFAR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAFAR
Middle Name:
Last Name:HAMIDI
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 1:26 STORM CIR
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16701-2752
Mailing Address - Country:US
Mailing Address - Phone:814-368-4581
Mailing Address - Fax:
Practice Address - Street 1:26 STORM CIR
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-2752
Practice Address - Country:US
Practice Address - Phone:814-368-4581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029372L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology