Provider Demographics
NPI:1013192327
Name:ALYKHAN, FUAD (MD)
Entity Type:Individual
Prefix:DR
First Name:FUAD
Middle Name:
Last Name:ALYKHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44320 PREMIER PLZ
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5077
Mailing Address - Country:US
Mailing Address - Phone:703-726-9056
Mailing Address - Fax:703-726-9058
Practice Address - Street 1:44320 PREMIER PLZ
Practice Address - Street 2:SUITE 120
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5076
Practice Address - Country:US
Practice Address - Phone:703-726-9056
Practice Address - Fax:703-726-9058
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101059077207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPTAN C11023OtherMEDICARE