Provider Demographics
NPI:1659930592
Name:BLUE RIDGE FAMILY CARE LLC
Entity Type:Organization
Organization Name:BLUE RIDGE FAMILY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BABAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-680-2256
Mailing Address - Street 1:225 OAK SPRINGS DR STE 101
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2186
Mailing Address - Country:US
Mailing Address - Phone:540-680-2256
Mailing Address - Fax:540-680-2495
Practice Address - Street 1:225 OAK SPRINGS DR STE 101
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2186
Practice Address - Country:US
Practice Address - Phone:540-680-2256
Practice Address - Fax:540-680-2495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-12
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101254071OtherVIRGINIA LICENSE