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General NPI Number Information
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NPI Number | 1689729451
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Entity Type | Individual
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Provider Name | ARMIN NAMAZIZADEH O.D., M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 11/09/2007
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Provider Practice Location Address
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Address Line | 2110 GALLOWS RD # C SUITE 2
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City | VIENNA
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State | VA
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Zip | 22182-3962
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Country | US
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Telephone | 703-918-0020
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Fax | 703-918-0026
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Provider Business Mailing Address
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Address Line | 933 WAR ADMIRAL ST
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City | GREAT FALLS
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State | VA
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Zip | 22066-2421
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Country | US
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Telephone | 703-405-8005
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Fax | 703-921-0026
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618001615
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License Number State | VA
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