Individual
RASOUL MOKABBERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 N ACADEMY AVE, GEISINGER MEDICAL CENTER, DANVILLE, PA 17822-9800
(216) 269-2654
(570) 271-1702
Mailing address
100 N ACADEMY AVE, GEISINGER MEDICAL CENTER, DANVILLE, PA 17822-9800
(216) 269-2654
(570) 271-1702
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35089082
OH
207RC0000X
Cardiovascular Disease Physician
A 95258
CA
207RC0000X
Cardiovascular Disease Physician
Primary
MD 435510
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35089082
LICENSE
OH
01
—
A 95258
LICENSE
CA
01
—
MD 435510
LICENSE
PA
01
—
TAX IDENTIFICATION
341898545
OH
Enumeration date
01/18/2007
Last updated
11/29/2021
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