Individual
EHSAN HABIBPOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6862 ELM ST STE 205, MC LEAN, VA 22101
(703) 821-1073
(703) 288-0767
Mailing address
6862 ELM ST STE 205, MC LEAN, VA 22101-3857
(703) 821-1073
(703) 288-0767
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101250561
VA
2084P0804X
Child & Adolescent Psychiatry Physician
0101250561
VA
Other
Enumeration date
06/29/2007
Last updated
02/11/2019
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