Organization
FAMILY HEALTH CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEHRAN KHAJAVI (OWNER/PHYSICIAN)
(304) 264-0888
Entity
Organization
Contact information
Practice address
1004 SUSHRUTA DR STE C, MARTINSBURG, WV 25401-8801
(304) 264-0888
(304) 264-0878
Mailing address
P.O. BOX 4458, LEESBURG, VA 20177
(703) 895-2237
(304) 264-0878
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
22758
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810026141
—
WV
01
—
C487
MEDICARE PTAN
WV
Enumeration date
10/18/2012
Last updated
02/11/2020
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