Healthcare Provider Details

I. General information

NPI: 1720552375
Provider Name (Legal Business Name): DR. SHAZMA AFTAB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2019
Last Update Date: 01/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2441 MARKET ST NE
WASHINGTON DC
20018-3840
US

IV. Provider business mailing address

14683 JOHN EWELL CT
CENTREVILLE VA
20121-6216
US

V. Phone/Fax

Practice location:
  • Phone: 202-269-8549
  • Fax:
Mailing address:
  • Phone: 703-509-3531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number25911
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202216991
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHI100003370
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: