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Individual

MRS. CAMELLIA MAZLOOMDOOST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
101 N EAGLE CREEK DR, LEXINGTON, KY 40509-1806
(859) 275-4878
Mailing address
101 N EAGLE CREEK DR, LEXINGTON, KY 40509-1806
(859) 275-4878
(859) 276-5400

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25685
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000049975
BLUE CROSS BLUE SHIELD
KY
05
64256852
KY
Enumeration date
01/31/2006
Last updated
06/04/2025
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