Healthcare Provider Details

I. General information

NPI: 1265635924
Provider Name (Legal Business Name): MOHAMAD ADHAM SALKENI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2007
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8613 ROUTE 29 # 200N
FAIRFAX VA
22031-2171
US

IV. Provider business mailing address

8613 ROUTE 29 # 101
FAIRFAX VA
22031-2171
US

V. Phone/Fax

Practice location:
  • Phone: 571-350-8400
  • Fax: 703-280-9596
Mailing address:
  • Phone: 571-350-8400
  • Fax: 703-208-3108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101275055
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number0101275055
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number0101275055
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number0101275055
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: