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General NPI Number Information
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NPI Number | 1629786181
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Entity Type | Organization
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Legal Business Name | CAPITAL LUNG
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Dates
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Enumeration Date | 11/14/2022
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Last Update Date | 11/14/2022
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Provider Practice Location Address
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Address Line | 8230 BOONE BLVD STE 203
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City | VIENNA
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State | VA
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Zip | 22182-2647
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Country | US
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Telephone | 703-636-9919
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Fax | 703-636-9452
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Provider Business Mailing Address
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Address Line | 9845 CORAL BELLS CT
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City | VIENNA
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State | VA
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Zip | 22182-1470
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Country | US
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Telephone | 703-636-9919
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR, OWNER
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Name | DR. PAYAM POOYAN
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Credential | MD
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Telephone | 703-636-9919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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