Individual
MAMAD MIRZA BAGHERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6100 TRAIL BLVD UNIT 307, NAPLES, FL 34108-2834
(951) 500-7286
Mailing address
6100 TRAIL BLVD UNIT 307, NAPLES, FL 34108-2834
(951) 500-7286
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
ME170386
FL
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
Q1792
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006759477
AETNA
—
05
—
14037
—
ND
01
—
154H3BA
BC BS MINNESOTA
ND
01
—
27619
BLUE CROSS BLUE SHIELD
ND
01
—
686405000
DEPT OF HUMAN SERVICES
MN
01
—
A82406
CA STATE MED LICENSE
CA
01
—
DF1942
RAILROAD MEDICARE GROUP
CA
01
—
P00346003
RAILROAD MEDICARE
CA
01
—
P00390315
RAILROAD MEDICARE
ND
01
—
ZZZ30167Z
MEDICARE NHIC
CA
Enumeration date
08/29/2006
Last updated
02/27/2026
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