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Individual

AMIR HOOTAN DARVISH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
750 WASHINGTON STREET, DEPT OF EMERGENCY MEDICINE, BOSTON, MA 02111
(617) 636-4720
Mailing address
331B PERKINS ST, JAMAICA PLAIN, MA 02130-4003
(917) 804-5628

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
225767
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02321153
NY
Enumeration date
11/16/2006
Last updated
09/10/2007
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