Provider Demographics
NPI:1629018304
Name:RASHID, MOHAMMAD KHURRAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:KHURRAM
Last Name:RASHID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KHURRAM
Other - Middle Name:
Other - Last Name:RASHID
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:17336 PICKWICK DR STE A
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-6180
Mailing Address - Country:US
Mailing Address - Phone:540-338-3360
Mailing Address - Fax:540-338-1975
Practice Address - Street 1:17336 PICKWICK DR
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-3143
Practice Address - Country:US
Practice Address - Phone:540-338-3360
Practice Address - Fax:540-338-1975
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101050539208D00000X
DCMD20827208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10238899OtherAMERIGROUP
VA1629018304Medicaid
VA5085233OtherAETNA
DCF352-0008OtherCAREFIRST BLUE CROSS BLUE SHIELD
VA10238899OtherAMERIGROUP