Organization
PLASTIC SURGERY AND DERMATOLOGY ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHABNAM SHAHABADI M.D. (CO-MANAGER)
(703) 645-0077
Entity
Organization
Contact information
Practice address
8501 ARLINGTON BLVD STE 310, FAIRFAX, VA 22031-4625
(703) 645-0077
Mailing address
PO BOX 8310, ROANOKE, VA 24014-0310
(703) 645-0077
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
0101243725
VA
208200000X
Plastic Surgery Physician
Primary
0101243338
VA
Other
Enumeration date
07/30/2008
Last updated
11/23/2020
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