Provider Demographics
NPI:1669982526
Name:CARIENT HEART & VASCULAR, LLC
Entity type:Organization
Organization Name:CARIENT HEART & VASCULAR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MERDOD
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAFOURI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:703-335-8750
Mailing Address - Street 1:8100 ASHTON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-5688
Mailing Address - Country:US
Mailing Address - Phone:703-335-8750
Mailing Address - Fax:571-358-3941
Practice Address - Street 1:8100 ASHTON AVE STE 200
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-5688
Practice Address - Country:US
Practice Address - Phone:703-335-8750
Practice Address - Fax:571-358-3941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-05
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101226688207RC0000X
VA0101057299207RC0000X
VA0101052820207RC0000X
VA0101255984207RC0000X
VA0101055791207RC0000X
VA0101047068207RC0000X
VA0101257865207RC0000X
VA0101243405207RC0001X
VA0101254202207RC0001X
VA0101057285207RC0000X
VA0101257877207RC0000X
VA0101257761207RC0001X
VA0102201022207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty