Individual
DR. SIAMAK HEYDARIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2200 OPITZ BLVD, SUITE 350, WOODBRIDGE, VA 22191-3321
(703) 497-6700
(703) 497-6300
Mailing address
2200 OPITZ BLVD, SUITE 350, WOODBRIDGE, VA 22191-3321
(703) 497-6700
(703) 497-6300
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101048248
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102386
AETNA
—
01
—
110228399
RR MEDICARE
—
01
—
1452619015
CIGNA
—
01
—
150789200
DEPT OF LABOR
—
01
—
194200
AMERIGROUP
—
01
—
289363
MAMSI
—
01
—
433755
ANTHEM BCBS
VA
05
—
5853451
—
VA
01
—
61910001
CAREFIRST BC BS
—
Enumeration date
06/15/2006
Last updated
01/16/2008
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