Individual
ROHAM MOFTAKHAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3 RICHLAND MEDICAL PARK DR, SUITE 310, COLUMBIA, SC 29203-6849
(803) 434-8323
(803) 434-8326
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
036-129390
IL
207T00000X
Neurological Surgery Physician
Primary
37893
SC
207T00000X
Neurological Surgery Physician
47499
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
378932
—
SC
Enumeration date
04/19/2006
Last updated
03/22/2018
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