Ettefagh, Keivan
Ettefagh, Keivan is an individual health care provider with primary practice located at 2707 Henry St , Greensboro NC 27405. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Ettefagh, Keivan can be contacted via phone (336) 574-4280.Contact Information
Primary practice address
2707 Henry St
Greensboro NC 27405
Phone: (336) 574-4280
Fax: (336) 574-4634
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD07109 | Rhode Island |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 2018-00348 | North Carolina |
Profile Details
| NPI number | 1144227729 |
|---|---|
| LBN Legal business name | Ettefagh, Keivan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2005 |
| Last updated | May 16th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144227729 | NPPES |
| Rhode Island | MEDICAID | 9002176 |
Popular Providers
-
Earls, Marian
1103 N Elm St Ste 300 , Greensboro NC 27401-6312 -
Wallace, Celeste Nicole
802 Green Valley Rd Suite 210, Greensboro NC 27408-7041 -
Reitnauer, Pamela Jean
1200 N Elm St , Greensboro NC 27401-1004 -
Pudlo, Ronald
510 N Elam Ave Ste 202, Greensboro NC 27403-1142 -
Lucas, Kathleen E
1416 Yanceyville St Ste 1, Greensboro NC 27405-6955 -
Summer, Jennifer G
4529 Jessup Grove Rd , Greensboro NC 27410-9407 -
Paul, Melinda Coover
301 E Wendover Ave Ste 400, Greensboro NC 27401-1230 -
Perez-Fiery, Denise
301 E Wendover Ave Ste 400, Greensboro NC 27401-1230