Individual
ALIREZA TAVASOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-0970
Mailing address
150 E WYNNEWOOD RD APT 28F, WYNNEWOOD, PA 19096-1508
(484) 343-3796
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
28224
ZZ
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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