Individual
DR. MITRA DASTGHEYB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
821 S KING ST STE A, LEESBURG, VA 20175-3914
(703) 777-3917
(703) 443-0100
Mailing address
821 S KING ST STE A, LEESBURG, VA 20175-3914
(703) 777-3917
(703) 443-0100
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
0101053042
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6030831
—
VA
Enumeration date
10/10/2006
Last updated
06/10/2008
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