Provider Demographics
NPI:1972911774
Name:DJAHANGIRIAN, ORCHIDEE (MD)
Entity type:Individual
Prefix:DR
First Name:ORCHIDEE
Middle Name:
Last Name:DJAHANGIRIAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 PATEWOOD DR STE A115
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3547
Mailing Address - Country:US
Mailing Address - Phone:864-454-5135
Mailing Address - Fax:
Practice Address - Street 1:200 PATEWOOD DR STE A115
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3547
Practice Address - Country:US
Practice Address - Phone:864-454-5135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-25
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC94281208800000X, 2088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
No208800000XAllopathic & Osteopathic PhysiciansUrology