Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 0101234406 | VA |
Y | 207VX0000X | Obstetrician | 0101234406 | VA |
NPI | 1437135803 |
---|---|
Provider Name | Tania Damavandy |
First Address | Falls Church, VA 22042-3307 |
Second Address | Falls Church, VA 22042 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2005 |
Last Update Date | 20/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010025028 | (05) | VA |
H99476 | (02) | VA |