Individual
DR. MJ HAJIANPOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
22 NEW SCOTLAND AVE DEPT OF, ALBANY, NY 12208-3795
(518) 262-5120
(518) 262-5924
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 433-6039
(423) 433-6060
Taxonomy
Speciality
Code
Description
License number
State
207SC0300X
Clinical Cytogenetics Physician
53464
TN
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
53464
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A483500
—
CA
01
—
37614470
TN GROUP MEDICARE
TN
01
—
A48350
MEDICAL LICENSE NUMBER
CA
Enumeration date
09/21/2006
Last updated
04/19/2022
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