Provider Demographics
NPI:1467194266
Name:SADROLSADOT, PAYMON (ND)
Entity Type:Individual
Prefix:DR
First Name:PAYMON
Middle Name:
Last Name:SADROLSADOT
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 SPRING GATE DR UNIT 9314
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-3421
Mailing Address - Country:US
Mailing Address - Phone:571-532-8487
Mailing Address - Fax:
Practice Address - Street 1:5225 WISCONSIN AVE NW STE 402
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2055
Practice Address - Country:US
Practice Address - Phone:202-237-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNP2000102175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath