Individual
HESAMODIN BORHANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1707 E 9TH ST, TRENTON, MO 64683-2641
(660) 339-8500
(660) 339-8507
Mailing address
1707 E 9TH ST, TRENTON, MO 64683-2641
(660) 339-8500
(660) 339-8507
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
105852
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912930975
—
MO
05
—
208478016
—
MO
Enumeration date
07/09/2006
Last updated
10/09/2024
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