Provider Demographics
NPI:1275378044
Name:POLYMATH PSYCHIATRIC PHYSICIANS, PLLC
Entity type:Organization
Organization Name:POLYMATH PSYCHIATRIC PHYSICIANS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAVEH
Authorized Official - Middle Name:CYRUS GHAEDI
Authorized Official - Last Name:GHAEDI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:707-932-5616
Mailing Address - Street 1:5321 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33707-6101
Mailing Address - Country:US
Mailing Address - Phone:707-932-5616
Mailing Address - Fax:617-507-7972
Practice Address - Street 1:5321 1ST AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33707-6101
Practice Address - Country:US
Practice Address - Phone:707-932-5616
Practice Address - Fax:617-507-7972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty