Provider Demographics
NPI:1881818060
Name:MAHIN BANOU BEIRAGHDAR DC PC
Entity Type:Organization
Organization Name:MAHIN BANOU BEIRAGHDAR DC PC
Other - Org Name:WASHINGTON SPINE AND DISC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHIN
Authorized Official - Middle Name:BANOU
Authorized Official - Last Name:BEIRAGHDAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:202-265-6000
Mailing Address - Street 1:PO BOX 5824
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-1424
Mailing Address - Country:US
Mailing Address - Phone:202-265-6000
Mailing Address - Fax:202-265-6018
Practice Address - Street 1:4123 CONNECTICUT AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-1155
Practice Address - Country:US
Practice Address - Phone:202-265-6000
Practice Address - Fax:202-265-6018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC000072880111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty