Individual
FARID DAKERMANDJI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 ARCH LN, LAW MOOR, VA 24457
(540) 345-3556
(540) 342-2193
Mailing address
PO BOX 8310, ROANOKE, VA 24014
(540) 345-3556
(540) 342-2193
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101027962
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5778115
—
VA
05
—
61841000
—
WV
01
—
64642
ANTHEM
VA
Enumeration date
05/15/2006
Last updated
07/08/2007
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