Healthcare Provider Details

I. General information

NPI: 1548172208
Provider Name (Legal Business Name): ANJUM (SIMI) SARFRAZ AHMED NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41801 INSPIRATION TER
ALDIE VA
20105-4617
US

IV. Provider business mailing address

41801 INSPIRATION TER
ALDIE VA
20105-4617
US

V. Phone/Fax

Practice location:
  • Phone: 571-723-1503
  • Fax:
Mailing address:
  • Phone: 571-723-1503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number390200000X
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: