Individual
DR. MEHRDAD TAVALLAEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2021 BANEY RD S STE A, ASHLAND, OH 44805-4574
(419) 289-1133
(419) 289-1132
Mailing address
2021 BANEY RD S STE A, ASHLAND, OH 44805-4574
(419) 289-1133
(419) 289-1132
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35079062T
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2247429
—
OH
Enumeration date
05/15/2006
Last updated
12/29/2020
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