Organization
AGELESS M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAI SEYEDAN (PARTNER)
(703) 688-2468
Entity
Organization
Contact information
Practice address
2221 N BUCHANAN ST, ARLINGTON, VA 22207-2526
(703) 688-2468
(703) 859-7689
Mailing address
2221 N BUCHANAN ST, ARLINGTON, VA 22207-2526
(703) 688-2468
(703) 859-7689
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
0101232169
VA
261QC1800X
Corporate Health Clinic/Center
0101232169
VA
261QV0200X
VA Clinic/Center
0101232169
VA
Other
Enumeration date
08/08/2012
Last updated
10/10/2015
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