Provider Demographics
NPI:1306881941
Name:ROYA AZARMAHAN, M.D.
Entity type:Organization
Organization Name:ROYA AZARMAHAN, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROYA
Authorized Official - Middle Name:
Authorized Official - Last Name:AZAR-MAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-812-3820
Mailing Address - Street 1:1715 N GEORGE MASON DR
Mailing Address - Street 2:SUITE 501
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3609
Mailing Address - Country:US
Mailing Address - Phone:703-812-3820
Mailing Address - Fax:703-812-3822
Practice Address - Street 1:1715 N GEORGE MASON DR
Practice Address - Street 2:SUITE 501
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3609
Practice Address - Country:US
Practice Address - Phone:703-812-3820
Practice Address - Fax:703-812-3822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101050996261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA334316OtherANTHEM
VA5820545OtherMEDICAID
VA5880166OtherAETNA
VA0400896OtherUNITED HEALTHCARE
VA334316OtherCAREFIRST B/C B/S
VA5880166OtherAETNA
VA334316OtherCAREFIRST B/C B/S