Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2815861 | NY |
N | 111NI0900X | Internist | 2815861 | NY |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 0101271271 | VA |
NPI | 1033475413 |
---|---|
Provider Name | Dr. Pedram Javanmard |
First Address | Falls Church, VA 22046-4300 |
Second Address | Falls Church, VA 22046-4300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2012 |
Last Update Date | 30/04/2021 |