Individual
MR. SHAH NOORISTANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12011 LEE JACKSON HWY STE 501, FAIRFAX, VA 22033-3315
(703) 725-3359
Mailing address
12011 LEE JACKSON HWY STE 501, FAIRFAX, VA 22033-3315
(703) 725-3359
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
0136000069
VA
246ZC0007X
Surgical Assistant
SA0165
DC
Other
Enumeration date
06/02/2015
Last updated
01/02/2019
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