Individual
SHOREH R FAZELI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FOGG RD, SOUTH WEYMOUTH, MA 02190-2432
(781) 340-8397
Mailing address
55 FOGG RD, SOUTH WEYMOUTH, MA 02190-2432
(781) 340-8397
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
281412
MA
Other
Enumeration date
05/04/2016
Last updated
08/31/2023
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