Healthcare Provider Details

I. General information

NPI: 1205464047
Provider Name (Legal Business Name): AHMAD NAVEED MAHMOODI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2020
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

14340 COMPTON VILLAGE DR
CENTREVILLE VA
20121-5700
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-8556
  • Fax: 202-444-8854
Mailing address:
  • Phone: 703-362-4244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number333209
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101283696
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: