Provider Demographics
NPI:1285968289
Name:SHAHVERDI, KEYVAN (DC)
Entity type:Individual
Prefix:DR
First Name:KEYVAN
Middle Name:
Last Name:SHAHVERDI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 MAPLE AVE W # 231
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-5612
Mailing Address - Country:US
Mailing Address - Phone:703-367-7878
Mailing Address - Fax:703-367-0009
Practice Address - Street 1:8420 DORSEY CIR STE 101
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-8300
Practice Address - Country:US
Practice Address - Phone:703-367-7878
Practice Address - Fax:703-367-0009
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556725111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor