Provider Demographics
NPI:1356316749
Name:HUMADI, SAHIRA ALI (MD)
Entity Type:Individual
Prefix:DR
First Name:SAHIRA
Middle Name:ALI
Last Name:HUMADI
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:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-446-5955
Mailing Address - Fax:757-446-5196
Practice Address - Street 1:825 FAIRFAX AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1914
Practice Address - Country:US
Practice Address - Phone:757-446-5955
Practice Address - Fax:757-446-5196
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235100207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2180439OtherUHC/MAMSI
VA-002 -003OtherTRICARE/CHAMPUS
VA267011OtherANTHEM BC/BS (GHENT FAMILY MEDICINE)
VAPAROtherCIGNA
VAPAROtherUSA MANAGED CARE
VA010021961Medicaid
VA267011OtherANTHEM BC/BS (PORTSMOUTH FAMILY MEDICINE)
VA72954OtherSENTARA OPTIMA
VAPAROtherMULTIPLAN
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherAETNA
NC066RFOtherBC/BS
VAPAROtherVA HEALTH NETWORK
NC89066RFMedicaid
VAPAROtherCORVEL/CORCARE
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VA2180439OtherUHC/MAMSI
VA-002 -003OtherTRICARE/CHAMPUS
VAPAROtherVIRGINIA PREMIER HEALTH