Individual
FATEMEH MIRZAMOHAMMADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD,PHD
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 676-8785
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2696
(176) 768-7856
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
1022749
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CDW960678657
BLUECROSS BLUESHIELD
MA
Enumeration date
04/03/2018
Last updated
01/14/2026
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