Basic Information
Provider Information
NPI: 1750843447
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NAMDARIZANDI
FirstName: VAHID
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD, MS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 375 DIXMYTH AVE
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452202475
CountryCode: US
TelephoneNumber: 5138623306
FaxNumber:  
Practice Location
Address1: 375 DIXMYTH AVE
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452202489
CountryCode: US
TelephoneNumber: 5138623306
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/02/2019
LastUpdateDate: 03/31/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/31/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X35.144171OHY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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