Provider Demographics
NPI:1336644426
Name:HOSSAINZADHA, SAHRA (MD)
Entity Type:Individual
Prefix:
First Name:SAHRA
Middle Name:
Last Name:HOSSAINZADHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20461 BLUE HERON TER
Mailing Address - Street 2:
Mailing Address - City:POTOMAC FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:20165-6571
Mailing Address - Country:US
Mailing Address - Phone:571-294-0732
Mailing Address - Fax:
Practice Address - Street 1:10510 JEFFERSON AVE STE B
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-3102
Practice Address - Country:US
Practice Address - Phone:757-594-3890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD92291207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program