Individual
MITRA ESHGHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
413 CENTERVILLE TPKE S, CHESAPEAKE, VA 23322-3907
(757) 482-4877
Mailing address
508 FAIR OAK DR, CHESAPEAKE, VA 23322-1270
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202211058
VA
183500000X
Pharmacist
19295
CO
Other
Enumeration date
09/05/2012
Last updated
09/05/2012
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