Derakhshan, Iraj
Derakhshan, Iraj is an individual health care provider with primary practice located at 1206 Quarrier St Suite 101, Charleston WV 25301-1810. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Derakhshan, Iraj can be contacted via phone (304) 343-4098.Contact Information
Primary practice address
1206 Quarrier St Suite 101
Charleston WV 25301-1810
Phone: (304) 343-4098
Fax: (304) 343-4598
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 18591 | West Virginia |
Profile Details
| NPI number | 1124088380 |
|---|---|
| LBN Legal business name | Derakhshan, Iraj |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 23rd, 2006 |
| Last updated | May 13th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124088380 | NPPES |
| West Virginia | Other | 000102711 | BCBS |
| West Virginia | MEDICAID | 0090508000 | BCBS |
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