Individual
SANAM BAGHSHOMALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
(215) 707-3040
(215) 707-8235
Mailing address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
(215) 707-8561
(215) 707-3677
Taxonomy
Speciality
Code
Description
License number
State
2084A2900X
Neurocritical Care Physician
Primary
01091792A
IN
2084N0400X
Neurology Physician
MD454539
PA
2084V0102X
Vascular Neurology Physician
MD454539
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/05/2009
Last updated
01/02/2024
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