Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 0101271952 | VA |
N | 111NI0900X | Internist | 0101271952 | VA |
N | 207R00000X | Internist | 4301105648 | MI |
N | 111NI0900X | Internist | 4301105648 | MI |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 0101271952 | VA |
N | 207RC0000X | Internist - Cardiovascular Disease | 0101271952 | VA |
N | 207RC0000X | Internist - Cardiovascular Disease | 4301501169 | MI |
NPI | 1780002295 |
---|---|
Provider Name | Iyad Isseh |
First Address | Baltimore, MD 21297-3174 |
Second Address | Falls Church, VA 22042-3307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2014 |
Last Update Date | 27/08/2021 |