Provider Demographics
NPI:1629044813
Name:PEREZ, CAROL BEZIRGANIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:BEZIRGANIAN
Last Name:PEREZ
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 1:3025 HAMAKER CT STE 290
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2237
Mailing Address - Country:US
Mailing Address - Phone:703-969-0781
Mailing Address - Fax:703-573-5429
Practice Address - Street 1:8550 ARLINGTON BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4634
Practice Address - Country:US
Practice Address - Phone:703-969-0781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2020-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010496172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC018375I65OtherMEDICARE NUMBER
DC018375I65OtherMEDICARE NUMBER
VAF83412Medicare UPIN