Individual
DR. SASAN GHAZVINIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 VFW PKWY, WEST ROXBURY, MA 02132-4927
(617) 323-7700
Mailing address
42 NEBO ST, MEDFIELD, MA 02052-2215
(617) 323-7700
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
36271
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36271
LICENSE
MA
Enumeration date
09/16/2006
Last updated
07/08/2007
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