Provider Demographics
NPI:1043357650
Name:PARVA, BEHZAD (MD)
Entity Type:Individual
Prefix:
First Name:BEHZAD
Middle Name:
Last Name:PARVA
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 1:224-D CORNWALL STREET, NW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176
Mailing Address - Country:US
Mailing Address - Phone:703-777-7477
Mailing Address - Fax:703-777-2050
Practice Address - Street 1:224-D CORNWALL STREET, NW
Practice Address - Street 2:SUITE 300
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176
Practice Address - Country:US
Practice Address - Phone:703-777-7477
Practice Address - Fax:703-777-2050
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101056821208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6901069Medicaid
VA240000223Medicare ID - Type Unspecified
VAF16885Medicare UPIN