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Individual

SHAYAN CHERAGHLOU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
725 S COLLEGE AVE, BLUEFIELD, VA 24605-1640
(276) 326-3376
Mailing address
725 S COLLEGE AVE, BLUEFIELD, VA 24605-1640
(215) 460-2117

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101285793
VA
207N00000X
Dermatology Physician
35110
WV
207ND0101X
MOHS-Micrographic Surgery Physician
81146
CT
390200000X
Student in an Organized Health Care Education/Training Program
709528
TX

Other

Enumeration date
04/28/2020
Last updated
06/12/2025
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