Individual
TAHIRA F MIRZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 FOGG RD, WEYMOUTH, MA 02190-2432
(781) 792-4121
(781) 878-6750
Mailing address
55 FOGG RD, COASTAL MEDICAL ASSOCIATES, SOUTH WEYMOUTH, MA 02190-2432
(781) 624-8000
(781) 878-6750
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036-119777
IL
2086S0102X
Surgical Critical Care Physician
042481
CT
2086S0102X
Surgical Critical Care Physician
Primary
257617
MA
2086S0102X
Surgical Critical Care Physician
4301072064
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036119777
—
IL
Enumeration date
02/06/2008
Last updated
08/24/2021
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