Healthcare Provider Details

I. General information

NPI: 1306881941
Provider Name (Legal Business Name): ROYA AZARMAHAN, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 11/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 N GEORGE MASON DR SUITE 501
ARLINGTON VA
22205-3609
US

IV. Provider business mailing address

1715 N GEORGE MASON DR SUITE 501
ARLINGTON VA
22205-3609
US

V. Phone/Fax

Practice location:
  • Phone: 703-812-3820
  • Fax: 703-812-3822
Mailing address:
  • Phone: 703-812-3820
  • Fax: 703-812-3822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number0101050996
License Number StateVA

VIII. Authorized Official

Name: MRS. ROYA AZAR-MAHAN
Title or Position: DOCTOR
Credential: M.D.
Phone: 703-812-3820