Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 0101232530 | VA |
NPI | 1164496675 |
---|---|
Provider Name | Dr. Bita Motesharrei |
First Address | Mc Lean, VA 22101-4451 |
Second Address | Mc Lean, VA 22101-4451 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 11/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H94570 | (02) | VA |