Provider Demographics
NPI:1386638732
Name:AHMAD, TAHIR (MD)
Entity Type:Individual
Prefix:DR
First Name:TAHIR
Middle Name:
Last Name:AHMAD
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:ENCOMPASS HEALTH REHABILIATION HOSPITAL OF NORTHERN VA
Mailing Address - Street 2:24430 MILLSTREAM DRIVE
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105
Mailing Address - Country:US
Mailing Address - Phone:703-957-2000
Mailing Address - Fax:610-617-6280
Practice Address - Street 1:ENCOMPASS HEALTH REHABILIATION HOSPITAL OF NORTHERN VA
Practice Address - Street 2:24430 MILLSTREAM DRIVE
Practice Address - City:ALDIE
Practice Address - State:VA
Practice Address - Zip Code:20105
Practice Address - Country:US
Practice Address - Phone:703-957-2000
Practice Address - Fax:610-617-6280
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36582207R00000X
VA0101232890207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010258251Medicaid
VA00X029C02Medicare ID - Type Unspecified