MEDICARE: WALEED MOHAMMED SYED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1073343919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WALEED MOHAMMED SYED

Provider Business Mailing Address
First Line	:	5236 FILLMORE AVE
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22311-1202
Country	:	US
Telephone Number	:	703-606-1756
Fax Number	:

Provider Business Practice Location Address
First Line	:	5236 FILLMORE AVE
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22311-1202
Country	:	US
Telephone Number	:	703-606-1756
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2024
Last Update Date	:	08/06/2024

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