Provider Demographics
NPI:1831572379
Name:AMJED, MADIHA (OD)
Entity type:Individual
Prefix:DR
First Name:MADIHA
Middle Name:
Last Name:AMJED
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 PINE ST
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4604
Mailing Address - Country:US
Mailing Address - Phone:703-471-7810
Mailing Address - Fax:703-471-6549
Practice Address - Street 1:17233 COLE RD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6981
Practice Address - Country:US
Practice Address - Phone:240-329-4699
Practice Address - Fax:240-329-4706
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002429152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist