Individual
DR. MEHRAK MOADDAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-3271
(508) 856-5911
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
295432
MA
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
295432
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110179413A
—
MA
Enumeration date
05/11/2018
Last updated
07/20/2023
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