Provider Demographics
NPI:1891725685
Name:SADJADI, PARVIZ M (MD)
Entity Type:Individual
Prefix:DR
First Name:PARVIZ
Middle Name:M
Last Name:SADJADI
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 1:1 ARH LANE, SUITE 900
Mailing Address - Street 2:P.O. BOX 174
Mailing Address - City:LOW MOOR
Mailing Address - State:VA
Mailing Address - Zip Code:24457
Mailing Address - Country:US
Mailing Address - Phone:540-862-6731
Mailing Address - Fax:540-862-6731
Practice Address - Street 1:1 ARH LANE
Practice Address - Street 2:
Practice Address - City:LOW MOOR
Practice Address - State:VA
Practice Address - Zip Code:24457
Practice Address - Country:US
Practice Address - Phone:540-862-6731
Practice Address - Fax:540-862-6742
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101022729174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7448775Medicaid
VAB59987Medicare UPIN