Provider Demographics
NPI:1447456033
Name:BABAKHANLOU, PEJMAN (MD)
Entity type:Individual
Prefix:DR
First Name:PEJMAN
Middle Name:
Last Name:BABAKHANLOU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W WALLACE ST STE B2
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1244
Mailing Address - Country:US
Mailing Address - Phone:419-422-3812
Mailing Address - Fax:
Practice Address - Street 1:300 W WALLACE ST STE B2
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1244
Practice Address - Country:US
Practice Address - Phone:419-422-3812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.010429208600000X
CAA 113674208600000X
OH35.149864208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery