Provider Demographics
NPI:1790564979
Name:HSMD
Entity Type:Organization
Organization Name:HSMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HASHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:STANAZAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-300-8827
Mailing Address - Street 1:42488 ROUGH ROCK CT
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152-3491
Mailing Address - Country:US
Mailing Address - Phone:703-300-8827
Mailing Address - Fax:
Practice Address - Street 1:42488 ROUGH ROCK CT
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20152-3491
Practice Address - Country:US
Practice Address - Phone:703-300-8827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care