Dibadj, Kourosh

Dibadj, Kourosh is an individual health care provider with primary practice located at 13135 Lee Jackson Memorial Hwy 135, Fairfax VA 22033-1907. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Dibadj, Kourosh can be contacted via phone (703) 961-0488.

Contact Information

Primary practice address
13135 Lee Jackson Memorial Hwy 135 Fairfax VA 22033-1907
Phone: (703) 961-0488
Fax: (703) 961-0480
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 0101241367 Virginia

Profile Details

NPI number 1487716593
LBN Legal business name Dibadj, Kourosh
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2006
Last updated Aug 11th, 2016 - about 9 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 1487716593 NPPES
Virginia MEDICAID 1487716593

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