Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 0101021336 | VA |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 0101021336 | VA |
NPI | 1023110426 |
---|---|
Provider Name | Ghassem A Nejad |
First Address | Woodbridge, VA 22191 |
Second Address | Woodbridge, VA 22191 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 05/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C61470 | (02) |