Individual
SAMAN GHAFFARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
33355 HEALTH CAMPUS BLVD, AVON, OH 44011-1399
(877) 749-7428
(512) 628-3314
Mailing address
1776 WOODSTEAD CT STE 208, THE WOODLANDS, TX 77380-1480
(877) 749-7428
(512) 628-3314
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
056446
GA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
34.013816
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0368269
—
OH
01
—
511G700757
MEDICARE GROUP
GA
05
—
599894070A
—
GA
Enumeration date
03/22/2007
Last updated
02/06/2020
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