MEDICARE: DR. NEZAM RADFAR 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
1	2080P0205X	Pediatric Endocrinology Physician	MD017837E	PA
2	207RA0401X	Addiction Medicine (Internal Medicine) Physician	MD017873E	PA

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

General Provider Information

NPI Number	:	1922004019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEZAM RADFAR M.D.

Provider Business Mailing Address
First Line	:	730 BROOKLINE BLVD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15226-2102
Country	:	US
Telephone Number	:	412-207-8874
Fax Number	:	412-892-9404

Provider Business Practice Location Address
First Line	:	730 BROOKLINE BLVD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15226-2102
Country	:	US
Telephone Number	:	412-207-8874
Fax Number	:	412-892-9404

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	10/30/2015

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