Organization
G. REZA MEHRYAR, M.D., NEUROLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GHOLAM REZA MEHRYAR M.D. (OWNER)
(703) 620-2929
Entity
Organization
Contact information
Practice address
3650 JOSEPH SIEWICK DR, #310, FAIRFAX, VA 22033-1710
(703) 620-2929
(703) 620-1711
Mailing address
3650 JOSEPH SIEWICK DR, #310, FAIRFAX, VA 22033-1710
(703) 620-2929
(703) 620-1711
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
22328
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100305
BLUE CROSS BLUE SHIELD
VA
Enumeration date
08/11/2006
Last updated
08/22/2020
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