Provider Demographics
NPI:1477596104
Name:ASHRAF, SYED SAUD (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:SAUD
Last Name:ASHRAF
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 1:4250 JOHN MARR DR
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3203
Mailing Address - Country:US
Mailing Address - Phone:703-854-1298
Mailing Address - Fax:703-854-1305
Practice Address - Street 1:4250 JOHN MARR DR
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3203
Practice Address - Country:US
Practice Address - Phone:703-854-1298
Practice Address - Fax:703-854-1305
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20934207R00000X
VA0101259349207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010207541Medicaid
WV1812624000Medicaid
WVP00286296OtherMEDICARE RAILROAD
H74029Medicare UPIN
WV4096495Medicare UPIN
WVP00286296OtherMEDICARE RAILROAD
H74029Medicare UPIN
WVAS4096494Medicare PIN