Healthcare Provider Details

I. General information

NPI: 1437707304
Provider Name (Legal Business Name): AHMED MOHAMED GABER ABDULHAMED PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2019
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 E PATRICK HENRY HWY
BURKEVILLE VA
23922-3454
US

IV. Provider business mailing address

4007 TUCKMAR POND DR
MOSELEY VA
23120-1986
US

V. Phone/Fax

Practice location:
  • Phone: 804-497-0191
  • Fax:
Mailing address:
  • Phone: 804-497-0191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024178182
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: