Healthcare Provider Details

I. General information

NPI: 1629719760
Provider Name (Legal Business Name): SHAYANN RAMEDANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW
WASHINGTON DC
20010-3017
US

IV. Provider business mailing address

1437 MCLEAN MEWS CT
MC LEAN VA
22101-3800
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-8640
  • Fax:
Mailing address:
  • Phone: 703-300-3026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD600005387
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: