Provider Demographics
NPI:1164639670
Name:SAEED, IBRAHIM M (MD)
Entity Type:Individual
Prefix:
First Name:IBRAHIM
Middle Name:M
Last Name:SAEED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2901 TELESTAR CT STE 300
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1263
Mailing Address - Country:US
Mailing Address - Phone:703-591-1688
Mailing Address - Fax:703-591-1445
Practice Address - Street 1:44035 RIVERSIDE PKWY STE 400
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-8260
Practice Address - Country:US
Practice Address - Phone:703-858-5421
Practice Address - Fax:703-858-9573
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101269161207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200678280AMedicaid
KS200678280BMedicaid
MO200516201Medicaid
KSKA2004054Medicare PIN
MOMA2491055Medicare PIN
H81727Medicare UPIN
MOMA2492055Medicare PIN
KS200678280AMedicaid