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:
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Health care specialties

SpecialtyCodeLicense #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 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124088380 NPPES
West Virginia Other 000102711 BCBS
West Virginia MEDICAID 0090508000 BCBS

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