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General NPI Number Information
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NPI Number | 1558396184
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Entity Type | Organization
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Legal Business Name | ALLEGHANY ANESTHESIA ASSOCIATES
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 08/30/2007
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Provider Practice Location Address
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Address Line | ONE ARCH LANE
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City | LOW MOOR
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State | VA
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Zip | 24457
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Country | US
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Telephone | 540-345-3556
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Fax | 540-342-2193
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Provider Business Mailing Address
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Address Line | PO BOX 8310
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City | ROANOKE
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State | VA
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Zip | 24014-0310
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Country | US
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Telephone | 540-345-3556
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Fax | 540-342-2193
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Authorized Official
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Title or Position | PRESIDENT
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Name | FARID DAKERMANDJI
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Credential | MD
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Telephone | 540-345-3556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | B59619
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License Number State | VA
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