Individual
KIANOUSH V REZAEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1675 E MAIN ST, BOX 328, KENT, OH 44240-5818
(330) 593-1048
(330) 572-3836
Mailing address
1675 E MAIN ST, BOX 328, KENT, OH 44240-5818
(330) 593-1048
(330) 572-3836
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35.125669
OH
2085R0202X
Diagnostic Radiology Physician
ME 101918
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0121669
—
OH
Enumeration date
06/03/2006
Last updated
08/29/2016
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