Provider Demographics
NPI:1700087202
Name:AFSHARCHI, FOROOZAN (MD)
Entity Type:Individual
Prefix:DR
First Name:FOROOZAN
Middle Name:
Last Name:AFSHARCHI
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 1:5000 COX RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-9263
Mailing Address - Country:US
Mailing Address - Phone:804-822-4355
Mailing Address - Fax:
Practice Address - Street 1:20209 SENTARA WAY
Practice Address - Street 2:STE 200
Practice Address - City:CARROLLTON
Practice Address - State:VA
Practice Address - Zip Code:23314-3573
Practice Address - Country:US
Practice Address - Phone:757-542-2000
Practice Address - Fax:757-542-2001
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116018283207Q00000X
VA0101244727207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1700087202Medicaid
WV3810015068Medicaid
020652R54Medicare PIN