Kaveh Ofogh, M.D

Primary specialty

Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X

License

01011052243 Issued in VA

Practice address

301 Concourse Blvd
Suite# 210
Glen Allen, VA 23059

Phone

(804) 433-1041

Fax

(804) 433-1050

NPI assigned

May 8, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300406400000",
    "number": "1487867958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 CONCOURSE BLVD",
            "address_2": "SUITE# 210",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "23059",
            "telephone_number": "804-433-1041",
            "fax_number": "804-433-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 CONCOURSE BLVD",
            "address_2": "SUITE# 210",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "23059",
            "telephone_number": "804-433-1041",
            "fax_number": "804-433-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OFOGH",
        "first_name": "KAVEH",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2011-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "VA",
            "license": "01011052243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adolescent Medicine (Internal Medicine) Physician in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Adolescent Medicine (Internal Medicine) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.