Provider Demographics
NPI:1750676789
Name:RASUL, SHEIKH M
Entity Type:Individual
Prefix:MR
First Name:SHEIKH
Middle Name:M
Last Name:RASUL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10901 WOODLAND FALLS DR
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-1536
Mailing Address - Country:US
Mailing Address - Phone:703-450-7550
Mailing Address - Fax:703-450-7550
Practice Address - Street 1:20600 GREAT FALLS PLAZA
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20164
Practice Address - Country:US
Practice Address - Phone:703-421-4020
Practice Address - Fax:703-421-2809
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202004912183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist