Healthcare Provider Details
I. General information
NPI: 1184321002
Provider Name (Legal Business Name): ALI M SAJADI MD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/10/2023
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2200 WILSON BLVD STE 102-18
ARLINGTON VA
22201-3397
US
IV. Provider business mailing address
2200 WILSON BLVD STE 102-18
ARLINGTON VA
22201-3397
US
V. Phone/Fax
- Phone: --
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208800000X |
| Taxonomy | Urology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ALI
M
SAJADI
Title or Position: OWNER
Credential: MD
Phone: 202-210-8366