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General NPI Number Information
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NPI Number | 1164676409
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Entity Type | Organization
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Legal Business Name | NASRIN EJTEMAEE MD PC
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Dates
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Enumeration Date | 11/13/2008
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Last Update Date | 11/13/2008
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Provider Practice Location Address
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Address Line | 8375A GREENSBORO DR
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City | MC LEAN
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State | VA
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Zip | 22102-3529
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Country | US
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Telephone | 703-893-8345
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Fax | 703-356-2730
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Provider Business Mailing Address
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Address Line | 8375A GREENSBORO DR
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City | MC LEAN
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State | VA
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Zip | 22102-3529
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Country | US
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Telephone | 703-893-8345
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Fax | 703-356-2730
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NASRIN EJTEMAEE
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Credential | M.D.
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Telephone | 703-893-8345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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