Provider Demographics
NPI:1699069898
Name:MESDAGHINIA, SEPEHR (MD)
Entity type:Individual
Prefix:DR
First Name:SEPEHR
Middle Name:
Last Name:MESDAGHINIA
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 1:821 S KING ST STE L
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-3922
Mailing Address - Country:US
Mailing Address - Phone:703-988-4142
Mailing Address - Fax:703-988-4147
Practice Address - Street 1:821 S KING ST STE L
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-3922
Practice Address - Country:US
Practice Address - Phone:703-988-4142
Practice Address - Fax:703-988-4147
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT199570207R00000X
DCMD043208208M00000X
VA0101263148207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty