Healthcare Provider Details

I. General information

NPI: 1649110735
Provider Name (Legal Business Name): NAZANIN YAZDAN POURI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NAZANIN YAZDANPOURI

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 FAIRFAX AVE, SUITE 11B EVMS FAMILY MEDICINE SUITE 118
NORFOLK VA
23507
US

IV. Provider business mailing address

8923 MONITOR WAY
NORFOLK VA
23503
US

V. Phone/Fax

Practice location:
  • Phone: 757-658-9737
  • Fax:
Mailing address:
  • Phone: 757-658-9737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: