Doctor Name: | NADER CYRUS EMAMI-KELISHADI |
NPI Number: | 1003120247 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 0110840510 |
Business Practice Address: | 3300 Gallows Rd Department Of Medicine Falls Church, VA - 220423307 |
Business Phone Number: | 7037763582 |
Business Fax Number: | 7037763020 |
Mailing Address: | 5576 Roan Chapel Dr, HAYMARKET |
State: | VA |
Postal Code: | 201692670 |
Phone Number: | 5712613476 |
Fax Number: | |
NPI Enumeration Date: | 07/29/2010 |
NPI Last Update Date: | 07/29/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 0110840510 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |