Provider Demographics
NPI:1881847127
Name:ROYA SEDGHI, M.D., PC
Entity Type:Organization
Organization Name:ROYA SEDGHI, M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEDGHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:703-256-4141
Mailing Address - Street 1:7501 LITTLE RIVER TPKE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2923
Mailing Address - Country:US
Mailing Address - Phone:703-256-4141
Mailing Address - Fax:703-256-6017
Practice Address - Street 1:7501 LITTLE RIVER TPKE
Practice Address - Street 2:SUITE 303
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2923
Practice Address - Country:US
Practice Address - Phone:703-256-4141
Practice Address - Fax:703-256-6017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-30
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052805207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC490659Medicare PIN
VAG66865Medicare UPIN