Provider Demographics
NPI:1124554860
Name:PEER TECHNOLOGIES PLLC
Entity Type:Organization
Organization Name:PEER TECHNOLOGIES PLLC
Other - Org Name:PEER CLINIC FOR BACK PAIN AND SPINE SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SOHAIL
Authorized Official - Middle Name:K
Authorized Official - Last Name:MIRZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:603-727-6647
Mailing Address - Street 1:4250 CHAIN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-4214
Mailing Address - Country:US
Mailing Address - Phone:703-828-6579
Mailing Address - Fax:571-458-7336
Practice Address - Street 1:4250 CHAIN BRIDGE RD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4214
Practice Address - Country:US
Practice Address - Phone:703-828-6579
Practice Address - Fax:571-458-7336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101261171207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty