Provider Demographics
NPI:1730249848
Name:NOWROUZZADEH, FARZAD (MD)
Entity type:Individual
Prefix:DR
First Name:FARZAD
Middle Name:
Last Name:NOWROUZZADEH
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 1:2544 COURT DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-3450
Mailing Address - Country:US
Mailing Address - Phone:704-854-9990
Mailing Address - Fax:704-854-9045
Practice Address - Street 1:2544 COURT DR
Practice Address - Street 2:SUITE G
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-3450
Practice Address - Country:US
Practice Address - Phone:704-854-9990
Practice Address - Fax:704-854-9045
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059669A207R00000X
NC2008-01272207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine