Individual
AZADEH KOOCHEKZADEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4660 KENMORE AVE, STE 500, ALEXANDRIA, VA 22304
(703) 212-6600
(703) 212-6606
Mailing address
1707 OSAGE ST, STE 104, ALEXANDRIA, VA 22302
(703) 212-6600
(703) 931-0961
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
101230323
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6792898
—
VA
Enumeration date
03/15/2006
Last updated
04/11/2013
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