Provider Demographics
NPI:1932484961
Name:SHAHIN, BAHMAN (MD)
Entity Type:Individual
Prefix:
First Name:BAHMAN
Middle Name:
Last Name:SHAHIN
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 1:8294 OLD COURTHOUSE RD STE A
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3871
Mailing Address - Country:US
Mailing Address - Phone:703-356-7882
Mailing Address - Fax:703-356-4850
Practice Address - Street 1:8294 OLD COURTHOUSE RD
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3871
Practice Address - Country:US
Practice Address - Phone:703-356-7882
Practice Address - Fax:703-356-4850
Is Sole Proprietor?:No
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101024447208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics