Provider Demographics
NPI:1053874107
Name:AZIZADDINI, SEYEDEH SHAHRZAD (MD)
Entity type:Individual
Prefix:
First Name:SEYEDEH SHAHRZAD
Middle Name:
Last Name:AZIZADDINI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 LEE ST BOX #800377
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22908-0816
Mailing Address - Country:US
Mailing Address - Phone:434-924-9400
Mailing Address - Fax:434-243-6731
Practice Address - Street 1:1215 LEE ST BOX #800377
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0816
Practice Address - Country:US
Practice Address - Phone:434-924-9400
Practice Address - Fax:434-243-6731
Is Sole Proprietor?:No
Enumeration Date:2019-04-07
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0116038860390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program