Provider Demographics
NPI:1124334180
Name:ASHKAN JAFARBAY MD PC
Entity type:Organization
Organization Name:ASHKAN JAFARBAY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHKAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JAFARBAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-598-5064
Mailing Address - Street 1:1146 WALKER RD
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-1838
Mailing Address - Country:US
Mailing Address - Phone:703-598-5064
Mailing Address - Fax:
Practice Address - Street 1:1146 WALKER RD
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:VA
Practice Address - Zip Code:22066-1838
Practice Address - Country:US
Practice Address - Phone:703-598-5064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235093207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty