Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 0101251568 | VA |
NPI | 1003048117 |
---|---|
Provider Name | Haidr Agha |
First Address | Virginia Beach, VA 23462-3666 |
Second Address | Virginia Beach, VA 23454 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2009 |
Last Update Date | 20/01/2022 |