MEDICARE: DR. NASSER GHAZVINI 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	207LP2900X	Pain Medicine (Anesthesiology) Physician	55945	VA

General Provider Information

NPI Number	:	1417036716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NASSER GHAZVINI MD

Provider Business Mailing Address
First Line	:	7015 WILLIAMSBURG BLVD
Second Line	:	SUITE B
City	:	ARLINGTON
State	:	VA
Zip	:	22213
Country	:	US
Telephone Number	:	703-533-0909
Fax Number	:	703-533-0075

Provider Business Practice Location Address
First Line	:	7015 WILLIAMSBURG BLVD
Second Line	:	SUITE B
City	:	ARLINGTON
State	:	VA
Zip	:	22213
Country	:	US
Telephone Number	:	703-533-0909
Fax Number	:	703-533-0075

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

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	07/08/2007

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