MEDICARE: DR. MEHDI SHEMIRANI MDFACS

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	208600000X	Surgery Physician	1005001	NY

General Provider Information

NPI Number	:	1790896330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEHDI SHEMIRANI MDFACS

Provider Business Mailing Address
First Line	:	1360 PORTLAND AVENUE
Second Line	:	SUITE 202
City	:	ROCHESTER
State	:	NY
Zip	:	14621-3002
Country	:	US
Telephone Number	:	585-342-6310
Fax Number	:	585-342-3245

Provider Business Practice Location Address
First Line	:	1360 PORTLAND AVENUE
Second Line	:	SUITE 202
City	:	ROCHESTER
State	:	NY
Zip	:	14621-3002
Country	:	US
Telephone Number	:	585-342-6310
Fax Number	:	585-342-3245

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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