Healthcare Provider Details

I. General information

NPI: 1093811341
Provider Name (Legal Business Name): MOHAMMAD E HOQUE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 11/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 N GEORGE MASON DR 344
ARLINGTON VA
22205-3683
US

IV. Provider business mailing address

4523 FAIRWAY DOWNS CT
ALEXANDRIA VA
22312
US

V. Phone/Fax

Practice location:
  • Phone: 703-717-4500
  • Fax: 703-717-4501
Mailing address:
  • Phone: 202-498-1307
  • Fax: 703-717-4501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD32822
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: