Provider Demographics
NPI:1073543088
Name:ARMANI, SHORE H (MD)
Entity Type:Individual
Prefix:DR
First Name:SHORE
Middle Name:H
Last Name:ARMANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 CHAIN BRIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101
Mailing Address - Country:US
Mailing Address - Phone:703-883-9696
Mailing Address - Fax:703-883-1982
Practice Address - Street 1:1580 CHAIN BRIDGE RD
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3503
Practice Address - Country:US
Practice Address - Phone:703-883-9696
Practice Address - Fax:703-883-1982
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101047629207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006062831Medicaid
VAF45698Medicare UPIN
VA006062831Medicaid