Healthcare Provider Details

I. General information

NPI: 1407981426
Provider Name (Legal Business Name): PARHAM JABERI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 12/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9501 LUCY CORR CIR
CHESTERFIELD VA
23832-6697
US

IV. Provider business mailing address

9501 LUCY CORR CIR
CHESTERFIELD VA
23832-6697
US

V. Phone/Fax

Practice location:
  • Phone: 804-751-4385
  • Fax: 804-751-4497
Mailing address:
  • Phone: 804-751-4385
  • Fax: 804-751-4497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberMD.200619
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number0101248571
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: