Provider Demographics
NPI:1629045729
Name:DAGHIGH, BEHNAM (MD)
Entity Type:Individual
Prefix:MR
First Name:BEHNAM
Middle Name:
Last Name:DAGHIGH
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:PO BOX 650668
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-0668
Mailing Address - Country:US
Mailing Address - Phone:703-726-9720
Mailing Address - Fax:703-726-9721
Practice Address - Street 1:19465 DEERFIELD AVE STE 101
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-1702
Practice Address - Country:US
Practice Address - Phone:703-726-9720
Practice Address - Fax:703-726-9721
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101056277207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010067138Medicaid
VAH37735Medicare UPIN