Provider Demographics
NPI:1992183446
Name:FERDOSIANNAJAFABADI, BEHROUZ (MD)
Entity Type:Individual
Prefix:
First Name:BEHROUZ
Middle Name:
Last Name:FERDOSIANNAJAFABADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BEHROUZ
Other - Middle Name:
Other - Last Name:FERDOSIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3123 PATRICK HENRY DR APT 326
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2331
Mailing Address - Country:US
Mailing Address - Phone:410-456-4484
Mailing Address - Fax:
Practice Address - Street 1:3123 PATRICK HENRY DR APT 326
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2331
Practice Address - Country:US
Practice Address - Phone:410-456-4484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-15
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY297358207R00000X
FLME145806207RC0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine