Provider Demographics
NPI:1881120657
Name:FATIMA, SYED FAHMIDA (PHARMD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:FAHMIDA
Last Name:FATIMA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 TOWNES PL
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405-2092
Mailing Address - Country:US
Mailing Address - Phone:571-234-7246
Mailing Address - Fax:
Practice Address - Street 1:45 TOWNES PL
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405-2092
Practice Address - Country:US
Practice Address - Phone:571-234-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202214231183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist