Provider Demographics
NPI:1639426497
Name:AHMAD, MIRIAM HINAA (MD)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:HINAA
Last Name:AHMAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 W BROAD ST STE 120
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4231
Mailing Address - Country:US
Mailing Address - Phone:703-534-6002
Mailing Address - Fax:703-534-7472
Practice Address - Street 1:103 W BROAD ST STE 120
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4231
Practice Address - Country:US
Practice Address - Phone:703-534-6002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-11
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101264135207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism