Taher, Mohammad Entezari

Taher, Mohammad Entezari is an individual health care provider with primary practice located at 212 S 1100 E , American Fork UT 84003-2829. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Taher, Mohammad Entezari can be contacted via phone (801) 763-0901.

Contact Information

Primary practice address
212 S 1100 E American Fork UT 84003-2829
Phone: (801) 763-0901
Fax: (801) 763-0903
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 7015A Wyoming
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 3445947-1205 Utah

Profile Details

NPI number 1992762918
LBN Legal business name Taher, Mohammad Entezari
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Oct 27th, 2022 - 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 1992762918 NPPES
Wyoming MEDICAID 119464000

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