Provider Demographics
NPI:1417952367
Name:ABDULSALAM, FARAH ZESHAN (MD)
Entity Type:Individual
Prefix:
First Name:FARAH
Middle Name:ZESHAN
Last Name:ABDULSALAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9205 WINDSOR MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-1600
Mailing Address - Country:US
Mailing Address - Phone:704-650-4045
Mailing Address - Fax:703-709-1697
Practice Address - Street 1:1890 METRO CENTER DR
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5286
Practice Address - Country:US
Practice Address - Phone:703-709-1500
Practice Address - Fax:703-709-1500
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2021-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101246942207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1377HOtherBCBS OF NC
NC7114107OtherCIGNA HEALTHCARE
NC7972594OtherAETNA
SCN0101EMedicaid
NC804963OtherPARTNERS MEDICARE
NC2482479OtherUNITED HEALTHCARE
NC891377HMedicaid
NCD7504OtherMEDCOST
NC2031316Medicare PIN
NC804963OtherPARTNERS MEDICARE
SCN0101EMedicaid