Individual
REZA MAHRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3114 CROASDAILE DR, SUITE 200, DURHAM, NC 27705-2508
(919) 425-1565
(919) 425-0478
Mailing address
3114 CROASDAILE DR, SUITE 200, DURHAM, NC 27705-2508
(919) 425-1565
(919) 425-0478
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
054315
GA
207P00000X
Emergency Medicine Physician
Primary
ME103889
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016386631C
—
GA
Enumeration date
09/22/2006
Last updated
12/22/2009
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