Individual
EHSAN JAZINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
11800 SUNRISE VALLEY DR STE 600, RESTON, VA 20191
(703) 709-1114
(703) 709-1117
Mailing address
11800 SUNRISE VALLEY DR STE 600, RESTON, VA 20191-5327
(703) 709-1114
(703) 709-1117
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101262789
VA
207X00000X
Orthopaedic Surgery Physician
49233
KY
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
0101262789
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017293178
—
DC
05
—
201379230
—
KY
05
—
7100422590
—
KY
05
—
870300100
—
MD
Enumeration date
06/23/2011
Last updated
03/02/2022
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