Provider Demographics
NPI:1871771733
Name:ZANDINEJAD, KEIVAN (MD)
Entity type:Individual
Prefix:DR
First Name:KEIVAN
Middle Name:
Last Name:ZANDINEJAD
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:PO BOX 62
Mailing Address - Street 2:TURNPIKE STATION
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-0062
Mailing Address - Country:US
Mailing Address - Phone:508-334-8815
Mailing Address - Fax:508-334-8105
Practice Address - Street 1:119 BELMONT ST
Practice Address - Street 2:HOSPITAL MEDICINE
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2903
Practice Address - Country:US
Practice Address - Phone:508-334-8515
Practice Address - Fax:508-334-6490
Is Sole Proprietor?:No
Enumeration Date:2008-02-03
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA237783207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine