Healthcare Provider Details

I. General information

NPI: 1811457245
Provider Name (Legal Business Name): ZVIADI ABURJANIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 01/11/2026
Certification Date: 01/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 VINCENT PL
MC LEAN VA
22101-3680
US

IV. Provider business mailing address

1307 VINCENT PL
MC LEAN VA
22101-3680
US

V. Phone/Fax

Practice location:
  • Phone: 703-821-1073
  • Fax:
Mailing address:
  • Phone: 703-821-1073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101286407
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: