Provider Demographics
NPI:1881913317
Name:MAGHSOUDLOU, HODJATOOLAH (MD)
Entity type:Individual
Prefix:DR
First Name:HODJATOOLAH
Middle Name:
Last Name:MAGHSOUDLOU
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 1:778 DEDHAM ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTER
Mailing Address - State:MA
Mailing Address - Zip Code:02459-3313
Mailing Address - Country:US
Mailing Address - Phone:617-965-2321
Mailing Address - Fax:
Practice Address - Street 1:778 DEDHAM ST
Practice Address - Street 2:
Practice Address - City:NEWTON CENTER
Practice Address - State:MA
Practice Address - Zip Code:02459-3313
Practice Address - Country:US
Practice Address - Phone:617-965-2321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program