Individual
JAVAD KHALILZADEH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
106 IRVING ST NW, SUITE 2000, WASHINGTON, DC 20010-2927
(202) 288-7777
Mailing address
104 PRETTYMAN DR, ROCKVILLE, MD 20850-4718
(202) 288-7777
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD30763
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017601000
MARYLAND MEDICAID
MD
05
—
032967300
—
DC
01
—
110217219
RAILROAD MEDICARE
DC
01
—
292374
MAMSI
DC
01
—
F195
BCBS
DC
Enumeration date
12/14/2005
Last updated
12/15/2009
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