Organization
INEUROHEADACHESPECIALIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAHAN CHEHRENAMA D.O. (MEDICAL DIRECTOR)
(703) 727-0771
Entity
Organization
Contact information
Practice address
7601 LEWINSVILLE RD, SUITE 460, MC LEAN, VA 22102-2814
(703) 828-9492
(703) 759-5361
Mailing address
7601 LEWINSVILLE RD, SUITE 460, MC LEAN, VA 22102-2814
(703) 828-9492
(703) 759-5361
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
0102050198
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447220421
PROVIDER NPI
VA
Enumeration date
11/28/2016
Last updated
11/28/2016
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