1609847060 NPI number — SEYED A. EMAMIAN M.D. , P.H. D.

Table of content: SEYED A. EMAMIAN M.D. , P.H. D. (NPI 1609847060)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609847060 NPI number — SEYED A. EMAMIAN M.D. , P.H. D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EMAMIAN
Provider First Name:
SEYED
Provider Middle Name:
A.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D. , P.H. D.
Provider Gender Code:
M

Provider's Other Name Information

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 Information

NPI Number:
1609847060
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9007
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTESVILLE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22906-9007
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
LEE ST FL 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLOTTESVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22908-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-243-0630
Provider Business Practice Location Address Fax Number:
434-982-1618
Provider Enumeration Date:
02/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  D0055402 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 0101222104 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CN2566 . This is a "MEDICARE RR" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 118303600 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: CD4495 . This is a "MEDICARE RR" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: KA80 . This is a "B/C B/S" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 2849 . This is a "B/C B/S" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 906S2WQ111 . This is a "MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: DD4343 . This is a "MEDICARE RR" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: J062 . This is a "B/C B/S" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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