MEDICARE: SIAVASH ZOLGHADRI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	MD034494L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285619882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIAVASH ZOLGHADRI MD

Provider Business Mailing Address
First Line	:	6 HEARTHSTONE CT
Second Line	:	SUITE 303
City	:	READING
State	:	PA
Zip	:	19606-3065
Country	:	US
Telephone Number	:	610-779-4449
Fax Number	:	610-779-0677

Provider Business Practice Location Address
First Line	:	6 HEARTHSTONE CT
Second Line	:	SUITE 303
City	:	READING
State	:	PA
Zip	:	19606-3065
Country	:	US
Telephone Number	:	610-779-4449
Fax Number	:	610-779-0677

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	03/03/2010

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