Provider Demographics
NPI:1245413822
Name:AZARMAHAN, ROYA (MD)
Entity Type:Individual
Prefix:
First Name:ROYA
Middle Name:
Last Name:AZARMAHAN
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:PO BOX 50005
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-5005
Mailing Address - Country:US
Mailing Address - Phone:703-812-3820
Mailing Address - Fax:703-812-3822
Practice Address - Street 1:1715 N GEORGE MASON DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205
Practice Address - Country:US
Practice Address - Phone:703-812-3820
Practice Address - Fax:703-812-3822
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101050996207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA334316OtherANTHEM
VA07360001OtherCAREFIRST
VA0400896OtherUNITED HEALTHCARE
VA5113132OtherCIGNA
VA5820545Medicaid
VA334316OtherANTHEM