Provider Demographics
NPI:1952417354
Name:MAHPAREH MOSTOUFIZADEH,MD,PC
Entity Type:Organization
Organization Name:MAHPAREH MOSTOUFIZADEH,MD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAHPAREH
Authorized Official - Middle Name:G
Authorized Official - Last Name:MOSTOUFIZADETH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-469-5728
Mailing Address - Street 1:PO BOX 9078
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-0078
Mailing Address - Country:US
Mailing Address - Phone:412-323-4402
Mailing Address - Fax:412-323-4418
Practice Address - Street 1:565 COAL VALLEY RD
Practice Address - Street 2:
Practice Address - City:CLAIRTON
Practice Address - State:PA
Practice Address - Zip Code:15025-3703
Practice Address - Country:US
Practice Address - Phone:412-469-5728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA124034OtherHIGHMARK/BLUE SHIELD
PA285463OtherFEDERAL BLACK LUNG
PA0011188290012Medicaid
PA0011188290012Medicaid