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NPI Code Detail

MEDICARE: DR. SAHAND VAFADARY M.D.

MEDICARE: DR. SAHAND VAFADARY 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
1207Q00000XFamily Medicine Physician66576AZ
2207Q00000XFamily Medicine PhysicianMD60916833WA

Other Identifiers

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

General Provider Information

NPI Number : 1760834204
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAHAND VAFADARY M.D.
Provider Business Mailing Address
First Line : 660 S COOLIDGE ST
Second Line :
City : MOSES LAKE
State : WA
Zip : 98837-1872
Country : US
Telephone Number : 509-793-9715
Fax Number : 509-764-3244
Provider Business Practice Location Address
First Line : 1075 S IDAHO RD STE 206
Second Line :
City : APACHE JUNCTION
State : AZ
Zip : 85119-6405
Country : US
Telephone Number : 480-827-5005
Fax Number : 480-827-5001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2016
Last Update Date : 03/14/2023

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