Provider Demographics
NPI:1487340329
Name:MAFI, MILAD
Entity type:Individual
Prefix:
First Name:MILAD
Middle Name:
Last Name:MAFI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 BLACKBERRY CT
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-2966
Mailing Address - Country:US
Mailing Address - Phone:716-480-1630
Mailing Address - Fax:
Practice Address - Street 1:LAKE CUMBERLAND REGIONAL HOSPITAL
Practice Address - Street 2:305 LANGDON STREET
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503
Practice Address - Country:US
Practice Address - Phone:606-679-7441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program