Provider Demographics
NPI:1245387794
Name:SEDGHI, SHIVA (MD)
Entity Type:Individual
Prefix:
First Name:SHIVA
Middle Name:
Last Name:SEDGHI
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 1:1145 19TH ST NW
Mailing Address - Street 2:SUITE 410
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036
Mailing Address - Country:US
Mailing Address - Phone:202-331-1740
Mailing Address - Fax:202-296-9784
Practice Address - Street 1:1145 19TH ST NW
Practice Address - Street 2:SUITE 410
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036
Practice Address - Country:US
Practice Address - Phone:202-331-1740
Practice Address - Fax:202-296-9784
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD20991207V00000X
VA0101221052207V00000X
MDD0046565207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F92568Medicare UPIN