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Individual

SEAN SHAHZAD DAILAMI-POUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
116 HAYDEN STREET, BELZONI, MS 39038
(662) 247-1252
(662) 247-3865
Mailing address
116 HAYDEN ST, BELZONI, MS 39038
(601) 859-5213
(601) 859-8771

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17099
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00124063
MS
05
0124063
MS
Enumeration date
01/02/2007
Last updated
07/18/2013
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