Seyed Mirfendereski, M.D.

Individual provider Active NPI Internal Medicine Physician · Warrensville HTS, OH

NPI 1235135161 · NPPES record last updated Jan 7, 2013

Key facts

NPI
1235135161
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
35-07-2710-M (OH)
Practice address
4180 Warrensville Ctr Rd.
120A
Warrensville HTS, OH 44122
Phone
(216) 491-7660
Fax
(216) 491-7662
NPI assigned
Jun 24, 2005
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35-07-2710-M OH Yes

Addresses

Primary practice location

4180 Warrensville Ctr Rd.
120A
Warrensville HTS, OH 44122

Mailing address

PO Box 391405
Solon, OH 44039
Phone (216) 491-7660

Other identifiers

IdentifierTypeStateIssuer
2446651MedicaidOH

Other providers in Warrensville HTS, OH

All providers in Warrensville HTS, OH · Internal Medicine Physician in Ohio

Sources for this page

Verify at the official NPI Registry.