Provider Demographics
NPI:1649251471
Name:AKBARIAN, MOHAMMED (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:
Last Name:AKBARIAN
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 1:12 SWAN ROAD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-3720
Mailing Address - Country:US
Mailing Address - Phone:339-221-0075
Mailing Address - Fax:781-979-3015
Practice Address - Street 1:611 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-1900
Practice Address - Country:US
Practice Address - Phone:781-756-7206
Practice Address - Fax:781-756-7274
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA29193207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2034263Medicaid
MA2034263Medicaid
A65822Medicare UPIN