Individual
IGRAR A ISMAIL-ZADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
123 SUMMER ST, WORCESTER, MA 01608-1216
(508) 363-6030
(774) 893-4132
Mailing address
12 ABBOTT RD, DOVER, MA 02030-1834
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD00040517
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0162989
L&I
—
Enumeration date
07/05/2006
Last updated
04/22/2020
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