Provider Demographics
NPI:1467409961
Name:FAROOQUE, ABDULLAH AL (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDULLAH
Middle Name:AL
Last Name:FAROOQUE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ABDULLAH
Other - Middle Name:AL
Other - Last Name:FAROOQUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 27
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20167-0027
Mailing Address - Country:US
Mailing Address - Phone:703-393-8883
Mailing Address - Fax:703-686-4240
Practice Address - Street 1:8609 SUDLEY RD
Practice Address - Street 2:SUITE 105
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4500
Practice Address - Country:US
Practice Address - Phone:703-393-8883
Practice Address - Fax:703-686-4240
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101227765207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005867568Medicaid
VAH32516Medicare UPIN
VA00V770V28Medicare PIN