Provider Demographics
NPI:1720552375
Name:AFTAB, SHAZMA
Entity Type:Individual
Prefix:DR
First Name:SHAZMA
Middle Name:
Last Name:AFTAB
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 1:14683 JOHN EWELL CT
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-6216
Mailing Address - Country:US
Mailing Address - Phone:703-509-3531
Mailing Address - Fax:
Practice Address - Street 1:2441 MARKET ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-3840
Practice Address - Country:US
Practice Address - Phone:202-269-8549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25911183500000X
VA0202216991183500000X
DCPHI100003370183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist