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General NPI Number Information
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NPI Number | 1366630576
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Entity Type | Organization
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Legal Business Name | AMIR ALIZADEH, MD, INC
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Dates
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Enumeration Date | 10/12/2007
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Last Update Date | 10/31/2007
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Provider Practice Location Address
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Address Line | 1637 MINERAL SPRING AVE SUITE 205
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02904-4042
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Country | US
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Telephone | 401-354-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 1637 MINERAL SPRING AVE SUITE 205
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02904-4042
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AMIR ALIZADEH
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Credential | M.D.
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Telephone | 401-354-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD09932
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License Number State | RI
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