Motakhaveri, Gholam Reza
Motakhaveri, Gholam Reza is an individual health care provider with primary practice located at 147 Reynoir Street Suite 204, Biloxi MS 39530. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Motakhaveri, Gholam Reza can be contacted via phone (228) 374-2051.Contact Information
Primary practice address
147 Reynoir Street Suite 204
Biloxi MS 39530
Phone: (228) 374-2051
Fax: (228) 374-5741
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 15627 | Mississippi |
Profile Details
| NPI number | 1790747269 |
|---|---|
| LBN Legal business name | Motakhaveri, Gholam Reza |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 3rd, 2006 |
| Last updated | Sep 30th, 2019 - about 6 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 | 1790747269 | NPPES |
| Mississippi | MEDICAID | 0118697 |
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