Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0214X | Pediatric Pulmonologist | ME90919 | FL |
NPI | 1538192281 |
---|---|
Provider Name | Shahriar Shahzeidi |
First Address | Leesburg, VA 20176-2704 |
Second Address | Leesburg, VA 20176-8272 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2006 |
Last Update Date | 10/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1538192281 | (05) | VA |
270303300 | (05) | FL |