Individual
BAHARAK BAGHERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5605 W EUGIE AVE STE 110, GLENDALE, AZ 85304-1273
(623) 847-2000
Mailing address
35 BROAD ST, APT #8, BANGOR, ME 04401-8305
(218) 760-9019
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
018430
ME
2085R0202X
Diagnostic Radiology Physician
Primary
45040
AZ
2085R0202X
Diagnostic Radiology Physician
50759
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
641184
—
AZ
05
—
PENDING
—
MN
Enumeration date
06/12/2008
Last updated
01/31/2019
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