Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD426805 | PA |
N | 111NI0900X | Internist | MD426805 | PA |
Y | 207RN0300X | Nephrologist | 0101256855 | VA |
N | 207RN0300X | Nephrologist | MD426805 | PA |
NPI | 1053304311 |
---|---|
Provider Name | Dr. Guita Ghadiri |
First Address | Midlothian, VA 23113-0693 |
Second Address | North Chesterfield, VA 23235-4311 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 07/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101322997 | (05) | PA |
1013229970001 | (05) | PA |
1545720 | GATEWAY-WMG (01) | PA |
1744727 | HIGHMARK BLUE SHIELD (01) | PA |
20082336 | AMERIHEALTH MERCY-WMG (01) | PA |
226982 | JOHNS HOPKINS (01) | PA |
259802 | UNISON-WMG (01) | PA |
3625 | GEISINGER HEALTH PLAN (01) | PA |
50082793 | CAPITAL BLUE CROSS-WMG (01) | PA |
947471 | CAREFIRST MD BCBS (01) | PA |
I34243 | (02) |