MEDICARE: DR. ROYA SEDGHI M.D.

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	207R00000X	Internal Medicine Physician	0101052805	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871517037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROYA SEDGHI M.D.

Provider Business Mailing Address
First Line	:	7501 LITTLE RIVER TPKE
Second Line	:	STE 303
City	:	ANNANDALE
State	:	VA
Zip	:	22003-2923
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7501 LITTLE RIVER TPKE
Second Line	:	STE 303
City	:	ANNANDALE
State	:	VA
Zip	:	22003-2923
Country	:	US
Telephone Number	:	703-256-4141
Fax Number	:	703-738-7310

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	01/02/2019

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