Provider Demographics
NPI:1770595480
Name:FEISEE, SEDDIGHEH A (MD)
Entity type:Individual
Prefix:
First Name:SEDDIGHEH
Middle Name:A
Last Name:FEISEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:301 MAPLE AVE W STE 420
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4301
Mailing Address - Country:US
Mailing Address - Phone:703-319-4162
Mailing Address - Fax:703-319-4163
Practice Address - Street 1:301 MAPLE AVE W STE 420
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4301
Practice Address - Country:US
Practice Address - Phone:703-319-4161
Practice Address - Fax:703-319-4163
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101025770207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
146273Medicare PIN