Healthcare Provider Details

I. General information

NPI: 1538192281
Provider Name (Legal Business Name): SHAHRIAR SHAHZEIDI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19441 GOLF VISTA PLZ STE 310
LEESBURG VA
20176-8272
US

IV. Provider business mailing address

PO BOX 3250
WINCHESTER VA
22604-2450
US

V. Phone/Fax

Practice location:
  • Phone: 703-729-3420
  • Fax: 703-729-3422
Mailing address:
  • Phone: 703-673-4490
  • Fax: 540-678-9025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberME90919
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License Number0101238030
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License NumberME90919
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License NumberD0053614
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: