Provider Demographics
NPI:1720423981
Name:VAZIRI-HARWOOD, SOGOL (RPH, PHARMD DENTAL)
Entity Type:Individual
Prefix:MRS
First Name:SOGOL
Middle Name:
Last Name:VAZIRI-HARWOOD
Suffix:
Gender:F
Credentials:RPH, PHARMD DENTAL
Other - Prefix:MRS
Other - First Name:SOGOL
Other - Middle Name:NAZARI
Other - Last Name:VARIRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:523 S CRANBROOK CROSS RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48301-3434
Mailing Address - Country:US
Mailing Address - Phone:248-990-6239
Mailing Address - Fax:248-616-0225
Practice Address - Street 1:523 S CRANBROOK CROSS RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48301-3434
Practice Address - Country:US
Practice Address - Phone:248-990-6239
Practice Address - Fax:248-616-0225
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program