Organization
BAHRAM FOROUZANDEH MD PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BAHRAM FOROUZANDEH MD (OWNER)
(606) 886-7471
Entity
Organization
Contact information
Practice address
5187 KY ROUTE 321, PRESTONSBURG, KY 41653-9114
(606) 886-7471
(606) 886-7473
Mailing address
PO BOX 1375, PRESTONSBURG, KY 41653-5375
(606) 886-7471
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6431205100
—
KY
01
—
DB3414
RAILROAD MEDICARE
KY
Enumeration date
12/07/2007
Last updated
05/19/2020
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