1235200155 NPI number — ALIDAD ARABSHAHI MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235200155 NPI number — ALIDAD ARABSHAHI MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

ARABSHAHI

Provider First Name:

ALIDAD

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1235200155

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

02/02/2024

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 1504

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

LORTON

Provider Business Mailing Address State Name:

VA

Provider Business Mailing Address Postal Code:

22199-1504

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

703-209-3208

Provider Business Mailing Address Fax Number:

703-619-5283

Provider First Line Business Practice Location Address:

1450 EMERSON AVE APT 402

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

MC LEAN

Provider Business Practice Location Address State Name:

VA

Provider Business Practice Location Address Postal Code:

22101-5751

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

703-988-7562

Provider Business Practice Location Address Fax Number:

703-660-4803

Provider Enumeration Date:

11/13/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207Y00000X , with the licence number:  0101234863 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 061724796 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
• Identifier: 010095735 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
• Identifier: 3529057 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
• Identifier: 6754313 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 677169 . This is a "NCPPO" identifier . This identifiers is of the category "OTHER".
• Identifier: 002463116 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 213793 . This is a "OPTIMUM CHOICE" identifier . This identifiers is of the category "OTHER".
• Identifier: 138060 . This is a "ANTHEM HMO GRP 13805" identifier . This identifiers is of the category "OTHER".
• Identifier: 7889561 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
• Identifier: 138060 . This is a "ANTHEM PPO GRP 13805" identifier . This identifiers is of the category "OTHER".
• Identifier: 297392 . This is a "AMERIGROUP" identifier . This identifiers is of the category "OTHER".
• Identifier: J9630001 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".
• Identifier: 061724796 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".
• Identifier: 2132793 . This is a "MAMSI ALLIANCE" identifier . This identifiers is of the category "OTHER".
• Identifier: 061724796 . This is a "TRICARE STANDARD" identifier . This identifiers is of the category "OTHER".