Provider Demographics
NPI:1063484806
Name:FESHAMI, BARBARA ANNE HARRIS (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANNE HARRIS
Last Name:FESHAMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:ANNE
Other - Last Name:HARRIS FESHAMI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:170 PROSPERITY DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602-5356
Mailing Address - Country:US
Mailing Address - Phone:540-869-0600
Mailing Address - Fax:
Practice Address - Street 1:170 PROSPERITY DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-5356
Practice Address - Country:US
Practice Address - Phone:540-869-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101255182207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ870031Medicaid
AZ32826OtherSTATE LICENSE
AZ32826OtherSTATE LICENSE
AZBF6108446OtherDEA
AZG97102Medicare UPIN