Provider Demographics
NPI:1558407437
Name:ZIA, JAMAL UDDIN (MD)
Entity Type:Individual
Prefix:
First Name:JAMAL
Middle Name:UDDIN
Last Name:ZIA
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 1:6231 LEESBURG PIKE STE 200
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2102
Mailing Address - Country:US
Mailing Address - Phone:703-533-8872
Mailing Address - Fax:703-533-8873
Practice Address - Street 1:6231 LEESBURG PIKE STE 200
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2102
Practice Address - Country:US
Practice Address - Phone:703-533-8872
Practice Address - Fax:703-533-8873
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012409756207Q00000X
VA0101240975207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
641678OtherMEDICARE PTAN
218394OtherMEDICARE PTAN