Provider Demographics
NPI:1982164349
Name:SHAYEGH, MEYSAM
Entity Type:Individual
Prefix:DR
First Name:MEYSAM
Middle Name:
Last Name:SHAYEGH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3636 16TH ST NW APT B762
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-1189
Mailing Address - Country:US
Mailing Address - Phone:626-633-2088
Mailing Address - Fax:
Practice Address - Street 1:HOWARD UNIVERSITY 2041 GEORGIA AVENUE NW ROOM 2066
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20060-0001
Practice Address - Country:US
Practice Address - Phone:626-633-2088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program