Healthcare Provider Details

I. General information

NPI: 1568526655
Provider Name (Legal Business Name): HAMDA GHAFFARI OBRIEN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12255 FAIR LAKES PARKWAY
FAIRFAX VA
22033-3952
US

IV. Provider business mailing address

2101 EAST JEFFERSON STREET PPQA MEDICARE COMPLIANCE UNIT 6 WEST ATTN THERESA BROOK
ROCKVILLE MD
20852-4908
US

V. Phone/Fax

Practice location:
  • Phone: 703-934-5905
  • Fax: 703-934-5778
Mailing address:
  • Phone: 301-816-6660
  • Fax: 301-816-6308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number0001108253
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: