Individual
DR. KHOSRO SHAREGHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., F.A.C.C.
Contact information
Practice address
2200 OPITZ BLVD, SUITE 310, WOODBRIDGE, VA 22191-3321
(703) 494-5995
(703) 491-9153
Mailing address
2200 OPITZ BLVD, SUITE 310, WOODBRIDGE, VA 22191-3321
(703) 494-5995
(703) 491-9153
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101042990
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006029833
—
VA
01
—
028689
HEALTHKEEPERS
—
01
—
028690
ANTHEM VIRGINIA
VA
01
—
1475-0001
CAREFIRST
—
01
—
4252028
AETNA
—
01
—
541739580
TRICARE
—
01
—
60-2983-3
FIRST HEALTH
—
Enumeration date
10/12/2005
Last updated
05/22/2013
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