Healthcare Provider Details

I. General information

NPI: 1831136845
Provider Name (Legal Business Name): MOHAMMAD FARIVAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 03/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

886 WASHINGTON ST MOHAMMAD FARIVAR, MD, PC
NORWOOD MA
02062-3466
US

IV. Provider business mailing address

886 WASHINGTON ST MOHAMMAD FARIVAR, MD, PC
NORWOOD MA
02062-3466
US

V. Phone/Fax

Practice location:
  • Phone: 781-762-3200
  • Fax: 781-769-7797
Mailing address:
  • Phone: 781-762-3200
  • Fax: 781-769-7797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number38815
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number38815
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: