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NPI Code Detail

MEDICARE: BEHJAT KOUCHEKZADEH M.D.

MEDICARE: BEHJAT KOUCHEKZADEH M.D.
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
1207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianME45824FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2ME45824OTHERFLLICENSE

General Provider Information

NPI Number : 1538186549
Entity Type Code : Individual
Provider Name (Legal Business Name) : BEHJAT KOUCHEKZADEH M.D.
Provider Business Mailing Address
First Line : 3581 S HIGHLANDS AVE
Second Line :
City : SEBRING
State : FL
Zip : 33870-5410
Country : US
Telephone Number : 863-385-5128
Fax Number : 863-385-7162
Provider Business Practice Location Address
First Line : 3581 S HIGHLANDS AVE
Second Line :
City : SEBRING
State : FL
Zip : 33870-5410
Country : US
Telephone Number : 863-385-5128
Fax Number : 863-385-7162
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2006
Last Update Date : 07/08/2007

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