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General NPI Number Information
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NPI Number | 1649704875
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Entity Type | Individual
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Provider Name | MOHAMMAD FARHAJ SHIRAZI M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/14/2017
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Last Update Date | 09/06/2024
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Provider Practice Location Address
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Address Line | 11800 SUNRISE VALLEY DR STE 500
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City | RESTON
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State | VA
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Zip | 20191-5316
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Country | US
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Telephone | 703-437-5977
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Fax | 703-478-2475
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Provider Business Mailing Address
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Address Line | 2901 TELESTAR CT STE 300
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City | FALLS CHURCH
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State | VA
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Zip | 22042-1263
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Country | US
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Telephone | 703-591-1688
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Fax | 703-591-1445
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 0101272211
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License Number State | VA
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