Provider Demographics
NPI:1871517037
Name:SEDGHI, ROYA (MD)
Entity type:Individual
Prefix:DR
First Name:ROYA
Middle Name:
Last Name:SEDGHI
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 1:7501 LITTLE RIVER TPKE
Mailing Address - Street 2:STE 303
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2923
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7501 LITTLE RIVER TPKE
Practice Address - Street 2:STE 303
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2923
Practice Address - Country:US
Practice Address - Phone:703-256-4141
Practice Address - Fax:703-738-7310
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052805207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5845432Medicaid
VA5845432Medicaid
490659Medicare ID - Type Unspecified