Mirza, Tahira F

Mirza, Tahira F is an individual health care provider with primary practice located at 55 Fogg Rd , Weymouth MA 02190-2432. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care. Allopathic & Osteopathic Physicians / Surgical Critical Care is her primary health care specialty. Mirza, Tahira F can be contacted via phone (781) 792-4121.

Contact Information

Primary practice address
55 Fogg Rd Weymouth MA 02190-2432
Phone: (781) 792-4121
Fax: (781) 878-6750
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 036-119777 Illinois
Allopathic & Osteopathic Physicians / Surgical Critical Care 2086S0102X 042481 Connecticut
Allopathic & Osteopathic Physicians / Surgical Critical Care 2086S0102X 4301072064 Michigan
Allopathic & Osteopathic Physicians / Surgical Critical Care 2086S0102X 257617 Massachusetts

Profile Details

NPI number 1063690691
LBN Legal business name Mirza, Tahira F
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2008
Last updated Aug 24th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063690691 NPPES
Illinois MEDICAID 036119777

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