Healthcare Provider Details

I. General information

NPI: 1104083260
Provider Name (Legal Business Name): OMAIR KHWAJA YOUSUF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1851 N GEORGE MASON DR STE 3C
ARLINGTON VA
22207-1953
US

IV. Provider business mailing address

3601 EISENHOWER AVE STE 220
ALEXANDRIA VA
22304-6457
US

V. Phone/Fax

Practice location:
  • Phone: 703-717-7780
  • Fax:
Mailing address:
  • Phone: 703-558-6941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number2016013255
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number0101272743
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number2016013255
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number04-38842
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: