Foroozesh, Mahtab Banej

Foroozesh, Mahtab Banej is an individual health care provider with primary practice located at 2001 Crystal Spring Ave Sw Ste 300 , Roanoke VA 24014-2465. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is her primary health care specialty. Foroozesh, Mahtab Banej can be contacted via phone (540) 985-8505.

Contact Information

Primary practice address
2001 Crystal Spring Ave Sw Ste 300 Roanoke VA 24014-2465
Phone: (540) 985-8505
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 0101-243723 Virginia
Other Service Providers / Specialist 174400000X 17959 Mississippi
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 0101-243723 Virginia

Profile Details

NPI number 1538104849
LBN Legal business name Foroozesh, Mahtab Banej
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 19th, 2006
Last updated Mar 5th, 2024 - about 9 months 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 1538104849 NPPES
Mississippi MEDICAID 03755090

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