MEDICARE: DR. CYRUS GOLSHANI 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
1	207W00000X	Ophthalmology Physician	0101267228	VA
2	207W00000X	Ophthalmology Physician	D0091753	MD
3	207W00000X	Ophthalmology Physician	35.133072	OH

General Provider Information

NPI Number	:	1972921864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYRUS GOLSHANI MD

Provider Business Mailing Address
First Line	:	3975 FAIR RIDGE DR STE 200
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22033-2911
Country	:	US
Telephone Number	:	703-289-0443
Fax Number	:

Provider Business Practice Location Address
First Line	:	3975 FAIR RIDGE DR STE 200
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22033-2911
Country	:	US
Telephone Number	:	703-289-0443
Fax Number	:

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

Provider Enumeration Date	:	03/28/2014
Last Update Date	:	10/16/2025

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