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General NPI Number Information
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NPI Number | 1720674138
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Entity Type | Individual
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Provider Name | SAHEL SEDGHAZAR
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Gender | Male
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Dates
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Enumeration Date | 12/19/2020
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Last Update Date | 12/19/2020
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Provider Practice Location Address
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Address Line | 7540 SPRING LAKE DR # A
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City | BETHESDA
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State | MD
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Zip | 20817-6540
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Country | US
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Telephone | 240-472-1494
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Fax |
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Provider Business Mailing Address
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Address Line | 7540 SPRING LAKE DR # A
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City | BETHESDA
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State | MD
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Zip | 20817-6540
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Country | US
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Telephone | 240-472-1494
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Fax |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 0019007996
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT1231
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | R01010
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License Number State | MD
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