Basic Information
| Provider Information | |||||||||
| NPI: | 1609847060 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EMAMIAN | ||||||||
| FirstName: | SEYED | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | M.D. , P.H. D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9007 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 229069007 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | LEE ST FL 1 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 229080001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4342430630 | ||||||||
| FaxNumber: | 4349821618 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2006 | ||||||||
| LastUpdateDate: | 02/07/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 02/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | D0055402 | MD | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 0101222104 | VA | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | CN2566 | 01 | MD | MEDICARE RR | OTHER | 118303600 | 05 | MD | MEDICAID | CD4495 | 01 | MD | MEDICARE RR | OTHER | KA80 | 01 | MD | B/C B/S | OTHER | 2849 | 01 | DC | B/C B/S | OTHER | 906S2WQ111 | 01 | NY | MEDICARE | OTHER | DD4343 | 01 | DE | MEDICARE RR | OTHER | J062 | 01 | MD | B/C B/S | OTHER |