Organization
MOSTAFA MIRHAIDARI, D.O.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOSTAFA MIRHAIDARI D.O. (OWNER)
(330) 364-8884
Entity
Organization
Contact information
Practice address
707 N WOOSTER AVE, DOVER, OH 44622-2866
(330) 364-8884
Mailing address
707 N WOOSTER AVE, DOVER, OH 44622-2866
(330) 364-8884
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34088184M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2544830
—
OH
01
—
P00282579
RAILROAD MEDICARE
OH
Enumeration date
11/05/2007
Last updated
02/20/2008
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