Provider Demographics
NPI:1013185206
Name:TABASSUM, NABEELA (MD)
Entity Type:Individual
Prefix:
First Name:NABEELA
Middle Name:
Last Name:TABASSUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7706 TOWER WOODS DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-2243
Mailing Address - Country:US
Mailing Address - Phone:610-905-9933
Mailing Address - Fax:
Practice Address - Street 1:4810 BEAUREGARD ST
Practice Address - Street 2:STE 303
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-1709
Practice Address - Country:US
Practice Address - Phone:703-750-0108
Practice Address - Fax:703-750-0230
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101249396207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine