Individual
MEHRAN BAJOGHLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1570 ONYX DR UNIT 305, MC LEAN, VA 22102-3957
(703) 244-9117
(571) 200-2618
Mailing address
1570 ONYX DR UNIT 305, MC LEAN, VA 22102-3957
(703) 244-9117
(571) 200-2618
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
0101231597
VA
207U00000X
Nuclear Medicine Physician
07395
VA
208D00000X
General Practice Physician
Primary
0101231597
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30016041500017
—
VA
01
—
6B8333
MEDICARE
—
Enumeration date
10/02/2006
Last updated
05/24/2024
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