Basic Information
| Provider Information | |||||||||
| NPI: | 1861610065 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAJI-MOMENIAN | ||||||||
| FirstName: | SHAHRIAR | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 658 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212030658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7038243200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8001 FORBES PL | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221512208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7038243200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2007 | ||||||||
| LastUpdateDate: | 05/26/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | LP00209 | RI | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.