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NPI Code Detail

MEDICARE: FATEMEH KHEDMATI MD

MEDICARE: FATEMEH KHEDMATI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician0101245856VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164659454
Entity Type Code : Individual
Provider Name (Legal Business Name) : FATEMEH KHEDMATI MD
Provider Business Mailing Address
First Line : 3600 JOSEPH SIEWICK DR
Second Line :
City : FAIRFAX
State : VA
Zip : 22033-1709
Country : US
Telephone Number : 703-391-3654
Fax Number : 703-391-3049
Provider Business Practice Location Address
First Line : 3600 JOSEPH SIEWICK DR
Second Line :
City : FAIRFAX
State : VA
Zip : 22033-1709
Country : US
Telephone Number : 703-391-3654
Fax Number : 703-391-3049
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2009
Last Update Date : 02/05/2026

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