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Individual

HOMAYOUN MODARRESIFAR

Active
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Individual

HOMAYOUN MODARRESIFAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
41198
AZ
207UN0902X
Nuclear Imaging & Therapy Physician
A93513
CA
207UN0902X
Nuclear Imaging & Therapy Physician
Primary
MD0000046850
TN
207UN0902X
Nuclear Imaging & Therapy Physician
N5255
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MD0000046850
TENNESSEE MEDICAL LICENSE
TN
Enumeration date
08/01/2006
Last updated
05/13/2011
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