Healthcare Provider Details

I. General information

NPI: 1073834412
Provider Name (Legal Business Name): SAEED TAHERI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2010
Last Update Date: 09/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 GREENSBORO DR SUITE 1050
MC LEAN VA
22102-3605
US

IV. Provider business mailing address

8300 GREENSBORO DR SUITE 1050
MC LEAN VA
22102-3605
US

V. Phone/Fax

Practice location:
  • Phone: 703-394-3400
  • Fax:
Mailing address:
  • Phone: 703-394-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101253541
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: