Provider Demographics
NPI:1003000126
Name:ENKESHAFI, ARDALAN (MD)
Entity Type:Individual
Prefix:
First Name:ARDALAN
Middle Name:
Last Name:ENKESHAFI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6410 ROCKLEDGE DR STE 304
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1841
Mailing Address - Country:US
Mailing Address - Phone:443-602-6207
Mailing Address - Fax:540-224-5684
Practice Address - Street 1:6410 ROCKLEDGE DR STE 304
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1841
Practice Address - Country:US
Practice Address - Phone:443-602-6207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0000290207R00000X
MDD0068455207R00000X
VA0101254037207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine