Organization
CAPITAL LUNG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAYAM POOYAN MD (MEDICAL DIRECTOR, OWNER)
(703) 636-9919
Entity
Organization
Contact information
Practice address
8230 BOONE BLVD STE 203, VIENNA, VA 22182-2647
(703) 636-9919
(703) 636-9452
Mailing address
9845 CORAL BELLS CT, VIENNA, VA 22182-1470
(703) 636-9919
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101257751
VA STATE BUSINESS LICENSE
VA
Enumeration date
11/14/2022
Last updated
11/14/2022
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