Healthcare Provider Details

I. General information

NPI: 1720614928
Provider Name (Legal Business Name): ABDULLAH HAFID MD, ND
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2020
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

526 N HENRY ST
ALEXANDRIA VA
22314-2233
US

IV. Provider business mailing address

5860 COLUMBIA PIKE STE 105
FALLS CHURCH VA
22041-2047
US

V. Phone/Fax

Practice location:
  • Phone: 703-348-9111
  • Fax: 703-888-3848
Mailing address:
  • Phone: 703-348-9111
  • Fax: 703-888-3848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number0101273272
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101273272
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101273272
License Number StateWV
# 4
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number0101273272
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: