Physician Compare National (NPI:1831287739)

HEALTHCARE PROVIDER: MITRA DASTGHEYB M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1831287739
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9335305515
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120717000353
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DASTGHEYB
	Individual professional last name
Provider First Name	MITRA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1985
	Individual professional's medical school graduation year
Primary Specialty	ENDOCRINOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	821 S KING ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE A
	Group Practice or individual's line 2 address
City	LEESBURG
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	201753914
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7037773917
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y