Provider Demographics
NPI:1720015654
Name:SALJUKI, RAFIQ M (MD)
Entity Type:Individual
Prefix:DR
First Name:RAFIQ
Middle Name:M
Last Name:SALJUKI
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 1:14904 JEFFERSON DAVIS HWY
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3908
Mailing Address - Country:US
Mailing Address - Phone:703-494-6182
Mailing Address - Fax:703-494-6627
Practice Address - Street 1:14904 JEFFERSON DAVIS HWY
Practice Address - Street 2:SUITE 302
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3908
Practice Address - Country:US
Practice Address - Phone:703-494-6182
Practice Address - Fax:703-494-6627
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238855207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
732435OtherNCPPO
3987265OtherAETNA HMO
VA010200539Medicaid
VA193203OtherANTHEM
7040720OtherAETNA PPO
732435OtherNCPPO
7040720OtherAETNA PPO