Provider Demographics
NPI:1831317593
Name:HABIB, MAHSIN (MD)
Entity type:Individual
Prefix:DR
First Name:MAHSIN
Middle Name:
Last Name:HABIB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:44121 HARRY BYRD HWY
Mailing Address - Street 2:SUITE 115
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5667
Mailing Address - Country:US
Mailing Address - Phone:703-724-4000
Mailing Address - Fax:703-724-4017
Practice Address - Street 1:44121 HARRY BYRD HWY
Practice Address - Street 2:SUITE 115
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5667
Practice Address - Country:US
Practice Address - Phone:703-724-4000
Practice Address - Fax:703-544-7791
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101230371207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VABH6980228OtherDEA
VABH6980228OtherDEA
VAG01515Medicare ID - Type Unspecified