Provider Demographics
NPI:1023252624
Name:MADISON FAMILY MEDICINE, PC
Entity type:Organization
Organization Name:MADISON FAMILY MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAMID
Authorized Official - Middle Name:S
Authorized Official - Last Name:ASSADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-261-6550
Mailing Address - Street 1:2555 CHAIN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22181
Mailing Address - Country:US
Mailing Address - Phone:703-261-6550
Mailing Address - Fax:703-261-6279
Practice Address - Street 1:2555 CHAIN BRIDGE RD
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22181
Practice Address - Country:US
Practice Address - Phone:703-261-6550
Practice Address - Fax:703-261-6279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101242970261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care