Provider Demographics
NPI:1194772665
Name:ARYAVAND, BEHDAD (MD)
Entity type:Individual
Prefix:DR
First Name:BEHDAD
Middle Name:
Last Name:ARYAVAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 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:703-358-3941
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
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101239944174400000X, 208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No174400000XOther Service ProvidersSpecialist
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010307881Medicaid
VA010307881Medicaid