Individual
DR. SIAMAC VAHABZADEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1605 E BROADWAY STE 110, COLUMBIA, MO 65201-8023
(573) 815-8130
(573) 815-8149
Mailing address
1605 E BROADWAY STE 110, COLUMBIA, MO 65201-8023
(573) 815-8130
(573) 815-8149
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2006022628
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
212587
BCBS
MO
01
—
2717460
UNITED HEATLH CARE
MO
01
—
307255
GHP
MO
01
—
763654
HEALTHLINK
MO
01
—
7895843
AETNA
MO
Enumeration date
11/20/2006
Last updated
12/20/2022
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