Individual
MINA KHORASHADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2100 DORCHESTER AVE, DORCHESTER, MA 02124-5615
(617) 296-4000
Mailing address
2100 DORCHESTER AVE, DORCHESTER, MA 02124-5615
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
11715222-1205
UT
207R00000X
Internal Medicine Physician
263502
MA
Other
Enumeration date
06/15/2015
Last updated
11/03/2021
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