| Doctor Name: | MAHMUD SABET SOGGE-KERMANI |
| NPI Number: | 1114108743 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 391 |
| Business Practice Address: | Rr 1 Box 67 Harlem, MT - 595269705 |
| Business Phone Number: | 4063533100 |
| Business Fax Number: | 4063533229 |
| Mailing Address: | Rr 1 Box 67, HARLEM |
| State: | MT |
| Postal Code: | 595269705 |
| Phone Number: | 4063533100 |
| Fax Number: | 4063533229 |
| NPI Enumeration Date: | 11/26/2007 |
| NPI Last Update Date: | 04/14/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 391 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |