Most Relevant Information
Provider Data
| NPI Number: | 1003502139 |
| Provider Name: | LUCAS MICHAEL DJAVAHERIAN |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/12/2023 |
| Last Updated: | 04/12/2023 |
Provider Practice Location
110 IRVING ST NW
WASHINGTON
DC
200103017
Practice Location Phone/Fax
| Phone: | 2028773536 |
| Fax: | 2028773699 |
Provider Mailing Location
110 IRVING ST NW
WASHINGTON
DC
200103017
Provider Mailing Phone/Fax
| Phone: | 2028773536 |
| Fax: | 2028773699 |