Provider Demographics
NPI:1225007677
Name:DURRANI, ABDUL W (MD)
Entity Type:Individual
Prefix:
First Name:ABDUL
Middle Name:W
Last Name:DURRANI
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 1:1012 WINSTON CHURCHILL DR
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860-5141
Mailing Address - Country:US
Mailing Address - Phone:804-458-8583
Mailing Address - Fax:804-541-2724
Practice Address - Street 1:1012 WINSTON CHURCHILL DR
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-5141
Practice Address - Country:US
Practice Address - Phone:804-458-8583
Practice Address - Fax:804-541-2724
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101028628207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007176520Medicaid
VA007176520Medicaid
VAC02208Medicare PIN
260000654Medicare ID - Type Unspecified