Provider Demographics
NPI:1184690661
Name:NOWROOZI, POURAN NADJI (MD)
Entity type:Individual
Prefix:DR
First Name:POURAN
Middle Name:NADJI
Last Name:NOWROOZI
Suffix:
Gender:F
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:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-625-0557
Mailing Address - Fax:757-625-1361
Practice Address - Street 1:160 KINGSLEY LN
Practice Address - Street 2:SUITE 205 DEPAUL ATRIUM
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-4600
Practice Address - Country:US
Practice Address - Phone:757-625-0557
Practice Address - Fax:757-625-1361
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034539207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA258983OtherANTHEM
VAPAROtherUSA MANAGED CARE
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALT/COVENTRY
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherVIRGINIA HEALTH NETWORK
VA006206972Medicaid
NC89064NFMedicaid
VAPAROtherTRICARE/CHAMPUS
VAPAROtherMULTIPLAN
VA14361OtherSENTARA OPTIMA
VAPAROtherCIGNA
VA10003529OtherSENTARA OPTIMA
VA1184690661Medicaid
VA2146283OtherUHC/MAMSI
VAPAROtherAETNA
VAPAROtherCORVEL/CORCARE
NC064NFOtherBC/BS
NC89064NFMedicaid
VA160001822Medicare PIN
VAPAROtherCIGNA