Healthcare Provider Details

I. General information

NPI: 1518943950
Provider Name (Legal Business Name): SHIRIN H. TRACHIOTIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 08/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 WILSON BLVD
ARLINGTON VA
20016-2695
US

IV. Provider business mailing address

1530 KEY BLVD #811
ARLINGTON VA
22209-1531
US

V. Phone/Fax

Practice location:
  • Phone: 202-537-4080
  • Fax: 202-537-4588
Mailing address:
  • Phone: 703-624-7866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD31614
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: