Provider Demographics
NPI:1386858470
Name:MAHDI, SAAD FAKHRI (MD)
Entity Type:Individual
Prefix:DR
First Name:SAAD
Middle Name:FAKHRI
Last Name:MAHDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6370 SPRINGFIELD PLZ
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-3431
Mailing Address - Country:US
Mailing Address - Phone:703-569-7554
Mailing Address - Fax:703-569-7410
Practice Address - Street 1:6370 SPRINGFIELD PLZ
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-3431
Practice Address - Country:US
Practice Address - Phone:703-569-7554
Practice Address - Fax:703-569-7410
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101230447207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0-493-833-8OtherECFMG
VA0101230447OtherBOARD OF MEDICINE LICENSE