Provider Demographics
NPI:1346565967
Name:SAMAD ORAEE, M.D., P.C.
Entity Type:Organization
Organization Name:SAMAD ORAEE, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ORAEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-492-7626
Mailing Address - Street 1:2050 OLD BRIDGE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-2481
Mailing Address - Country:US
Mailing Address - Phone:703-492-7626
Mailing Address - Fax:703-492-7537
Practice Address - Street 1:2050 OLD BRIDGE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2481
Practice Address - Country:US
Practice Address - Phone:703-492-7626
Practice Address - Fax:703-492-7537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-07
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101049783204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty