MEDICARE: ELAHE BORDBAR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	0101279024	VA

General Provider Information

NPI Number	:	1306374954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELAHE BORDBAR MD

Provider Business Mailing Address
First Line	:	1635 N GEORGE MASON DR STE 420
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22205-3617
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1635 N GEORGE MASON DR STE 420
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22205-3617
Country	:	US
Telephone Number	:	703-536-4000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2017
Last Update Date	:	02/25/2026

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