Individual
SIAMAK SHAHMOHAMMADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA
Contact information
Practice address
805 EAGLERIDGE BLVD, SUITE #50, PUEBLO, CO 81008-2193
(719) 584-7415
(719) 542-7019
Mailing address
805 EAGLERIDGE BLVD, SUITE #50, PUEBLO, CO 81008-2193
(719) 584-7415
(719) 542-7019
Taxonomy
Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
—
—
Other
Enumeration date
03/19/2009
Last updated
03/19/2009
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