Provider Demographics
NPI:1962674150
Name:MOJADADDI, HUMAIRA (MD)
Entity type:Individual
Prefix:DR
First Name:HUMAIRA
Middle Name:
Last Name:MOJADADDI
Suffix:
Gender:F
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 40370
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89504-4370
Mailing Address - Country:US
Mailing Address - Phone:775-770-6490
Mailing Address - Fax:775-770-3944
Practice Address - Street 1:235 W 6TH ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4548
Practice Address - Country:US
Practice Address - Phone:775-770-6490
Practice Address - Fax:775-770-3944
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA127334207R00000X, 207RC0200X, 208M00000X
NV14075208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine