Individual
DR. MEHRAN KHAJAVI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1004 SUSHRUTA DR STE C, MARTINSBURG, WV 25401-8801
(304) 264-0888
(304) 264-0878
Mailing address
P.O. BOX 4458, LEESBURG, VA 20177
(703) 895-2237
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
0101241072
VA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
22758
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00449865
RAILROAD MEDICARE
WV
01
—
WV2358C487
MEDICARE PTAN
WV
Enumeration date
04/24/2007
Last updated
09/18/2023
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