Dideban, Bahram

Dideban, Bahram is an individual health care provider with primary practice located at 18741 High Springs Main St , High Springs FL 32643-0074. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Dideban, Bahram can be contacted via phone (786) 300-7808.

Contact Information

Primary practice address
18741 High Springs Main St High Springs FL 32643-0074
Phone: (786) 300-7808
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME136670 Florida

Profile Details

NPI number 1992189948
LBN Legal business name Dideban, Bahram
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2015
Last updated Jun 20th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992189948 NPPES
Florida MEDICAID 100007200

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