Provider Demographics
NPI:1912157009
Name:SOLOMON, HORMOZ (MD)
Entity Type:Individual
Prefix:
First Name:HORMOZ
Middle Name:
Last Name:SOLOMON
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 1:101 INDUSTRIAL PARK RD STE 700
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-7393
Mailing Address - Country:US
Mailing Address - Phone:508-880-3121
Mailing Address - Fax:088-800-9265
Practice Address - Street 1:101 INDUSTRIAL PARK RD STE 700
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-7393
Practice Address - Country:US
Practice Address - Phone:508-880-3121
Practice Address - Fax:088-800-9265
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60055120207K00000X
NY237436207K00000X, 208000000X
MA274821207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8533150Medicaid
WA8533150Medicaid