Organization
CHANTILLY FOOT & ANKLE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FARSHAD BATHAEE DPM (OWNER)
(703) 490-5599
Entity
Organization
Contact information
Practice address
4080 LAFAYETTE CENTER DR, SUITE 170, CHANTILLY, VA 20151-1247
(703) 490-5599
(703) 766-5047
Mailing address
PO BOX 220734, CHANTILLY, VA 20153-0734
(703) 490-5599
(703) 766-5047
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0103300742
VA
Other
Enumeration date
10/19/2006
Last updated
08/22/2020
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