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NPI Code Detail

MEDICARE: DR. MOOJAN ROUHI OD

MEDICARE: DR. MOOJAN ROUHI OD
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
1152W00000XOptometrist3466MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2W15831OTHERMABLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1912986134
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MOOJAN ROUHI OD
Provider Business Mailing Address
First Line : 65 HUTCHINS RD
Second Line :
City : CARLISLE
State : MA
Zip : 01741-1027
Country : US
Telephone Number : 978-371-8026
Fax Number : 978-686-0682
Provider Business Practice Location Address
First Line : 65 HUTCHINS RD
Second Line :
City : CARLISLE
State : MA
Zip : 01741-1027
Country : US
Telephone Number : 978-371-8026
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2006
Last Update Date : 10/22/2008

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Directions to “ DR. MOOJAN ROUHI OD” Practice Location

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