Provider Demographics
NPI:1952328031
Name:HAFIZI, GHAZALEH GIGI (MD)
Entity Type:Individual
Prefix:DR
First Name:GHAZALEH
Middle Name:GIGI
Last Name:HAFIZI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 WOODBURN RD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-1229
Mailing Address - Country:US
Mailing Address - Phone:703-573-7772
Mailing Address - Fax:703-573-7775
Practice Address - Street 1:3301 WOODBURN RD
Practice Address - Street 2:SUITE 307
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-1229
Practice Address - Country:US
Practice Address - Phone:703-573-7772
Practice Address - Fax:703-573-7775
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053805207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006215262Medicaid
VAF96188Medicare UPIN
VA006215262Medicaid