Provider Demographics
NPI:1275545196
Name:MURTAZA, SYED J (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:J
Last Name:MURTAZA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:15532 MELLON CT
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169-6164
Mailing Address - Country:US
Mailing Address - Phone:240-669-2470
Mailing Address - Fax:301-460-1944
Practice Address - Street 1:15532 MELLON CT
Practice Address - Street 2:
Practice Address - City:HAYMARKET
Practice Address - State:VA
Practice Address - Zip Code:20169-6164
Practice Address - Country:US
Practice Address - Phone:240-669-2470
Practice Address - Fax:301-460-1944
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101238282207RS0012X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1275545196Medicaid
VA017619P82Medicare PIN