Individual
IDEAN AMIRJAZIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1880 AMHERST STREET, SUITE 100 AND SUITE 200, WINCHESTER, VA 22601-6254
(540) 662-0306
(855) 264-2066
Mailing address
220 CAMPUS BLVD STE 100, WINCHESTER, VA 22601-2896
(540) 536-5100
(540) 536-0235
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101268593
VA
207RC0000X
Cardiovascular Disease Physician
29563
WV
282N00000X
General Acute Care Hospital
MT207582
PA
Other
Enumeration date
06/24/2014
Last updated
09/14/2021
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