Dr. Kourosh Dibadj, M.D.
Internal Medicine, Nephrology in Fairfax, VA. Individual provider (NPI-1).
NPI number1487716593
StatusActive
Last updated in NPPESAug 11, 2016
Details
- NPI
- 1487716593
- Entity type
- Individual (NPI-1)
- Name
- Dr. Kourosh Dibadj
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 14, 2006
- Last updated
- Aug 11, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RN0300X | Internal Medicine, Nephrology | 0101241367 | VA | Yes |
Practice location
13135 Lee Jackson Memorial Hwy135
Fairfax, VA 22033-1907
Phone 703-961-0488 · Fax 703-961-0480
Mailing address
13135 Lee Jackson Memorial Hwy135
Fairfax, VA 22033-1907
Phone 703-961-0488 · Fax 703-961-0480
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