MEDICARE: DR. FARZAD MOSHIR ESFAHANI 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	ME68692	FL
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	18539	AL

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
2	32188	OTHER	FL	BCBS OF FL

General Provider Information

NPI Number	:	1619919131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FARZAD MOSHIR ESFAHANI MD

Provider Business Mailing Address
First Line	:	PO BOX 55309
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35255-5309
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	619 19TH ST S
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35249-4108
Country	:	US
Telephone Number	:	205-934-4011
Fax Number	:

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

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	08/22/2019

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