MEDICARE: SHAHIN SADEGHI ALAVIJEH DC

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
1	111N00000X	Chiropractor	0104557316	VA

General Provider Information

NPI Number	:	1427405026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAHIN SADEGHI ALAVIJEH DC

Provider Business Mailing Address
First Line	:	2300 N PERSHING DR STE 204
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22201-1428
Country	:	US
Telephone Number	:	703-525-5800
Fax Number	:	703-525-5802

Provider Business Practice Location Address
First Line	:	2300 N PERSHING DR STE 204
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22201-1428
Country	:	US
Telephone Number	:	703-525-5800
Fax Number	:	703-525-5802

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2016
Last Update Date	:	05/24/2016

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