Provider Demographics
NPI:1790362150
Name:AHMADI, ZAINAB
Entity Type:Individual
Prefix:
First Name:ZAINAB
Middle Name:
Last Name:AHMADI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2987 DISTRICT AVE APT 418
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-1517
Mailing Address - Country:US
Mailing Address - Phone:703-980-8534
Mailing Address - Fax:
Practice Address - Street 1:14113 ROBERT PARIS CT
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-4200
Practice Address - Country:US
Practice Address - Phone:703-956-6757
Practice Address - Fax:855-359-2261
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024180608207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine