Provider Demographics
NPI:1699748590
Name:VISTAMEHR, SETAREH (MD)
Entity type:Individual
Prefix:DR
First Name:SETAREH
Middle Name:
Last Name:VISTAMEHR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 WHITNEY MILL WAY
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-5724
Mailing Address - Country:US
Mailing Address - Phone:203-915-8434
Mailing Address - Fax:301-570-2020
Practice Address - Street 1:11119 ROCKVILLE PIKE
Practice Address - Street 2:SUITE 318
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3143
Practice Address - Country:US
Practice Address - Phone:301-570-2020
Practice Address - Fax:301-570-2021
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD 0069332174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist