Individual
MR. SIAVASH GHOREISHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD06842
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1200203
UHC
—
01
—
201159
BLUE CHIP
—
01
—
2684
BC
—
01
—
406185
TUTTS
—
05
—
SG00062
—
RI
Enumeration date
09/20/2006
Last updated
05/08/2013
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