Provider Demographics
NPI:1427347293
Name:SAMZADEH, SEPIDEH (MD, MS)
Entity type:Individual
Prefix:DR
First Name:SEPIDEH
Middle Name:
Last Name:SAMZADEH
Suffix:
Gender:F
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4442 LOUISE AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3918
Mailing Address - Country:US
Mailing Address - Phone:818-395-0603
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR RM 4601
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506-1200
Practice Address - Country:US
Practice Address - Phone:304-293-7542
Practice Address - Fax:304-293-5709
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA131269207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology