Healthcare Provider Details

I. General information

NPI: 1992292882
Provider Name (Legal Business Name): SEHAR MARUF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2018
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3914 CENTREVILLE RD STE 101
CHANTILLY VA
20151-3289
US

IV. Provider business mailing address

2455 MANDEVILLE LN APT 824
ALEXANDRIA VA
22314-6136
US

V. Phone/Fax

Practice location:
  • Phone: 703-481-8600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101276233
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0093535
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301509360
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: