Provider Demographics
NPI:1316431430
Name:NOSHIRVAN, ARRAM (MD)
Entity type:Individual
Prefix:
First Name:ARRAM
Middle Name:
Last Name:NOSHIRVAN
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 1:724 SOLANO DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-7739
Mailing Address - Country:US
Mailing Address - Phone:714-272-7252
Mailing Address - Fax:505-923-8586
Practice Address - Street 1:1100 CENTRAL AVE SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4934
Practice Address - Country:US
Practice Address - Phone:505-923-5941
Practice Address - Fax:505-923-8586
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM390200000X
NMMD2023-0295207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program