Provider Demographics
NPI:1598099111
Name:SHOLEHVAR, JAVAD (MD)
Entity Type:Individual
Prefix:DR
First Name:JAVAD
Middle Name:
Last Name:SHOLEHVAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049-1933
Mailing Address - Country:US
Mailing Address - Phone:484-788-9674
Mailing Address - Fax:484-788-9674
Practice Address - Street 1:708 EAGLE DR
Practice Address - Street 2:
Practice Address - City:EMMAUS
Practice Address - State:PA
Practice Address - Zip Code:18049-1933
Practice Address - Country:US
Practice Address - Phone:484-788-9674
Practice Address - Fax:484-788-9674
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-29
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 031405 L207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology