Healthcare Provider Details

I. General information

NPI: 1851525034
Provider Name (Legal Business Name): UNITED DOCTORS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2009
Last Update Date: 04/17/2020
Certification Date: 04/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2812 OLD LEE HWY STE 210B
FAIRFAX VA
22031-4367
US

IV. Provider business mailing address

PO BOX 2285
CENTREVILLE VA
20122-2285
US

V. Phone/Fax

Practice location:
  • Phone: 703-573-0086
  • Fax:
Mailing address:
  • Phone: 301-742-1704
  • Fax: 703-620-6628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101244167
License Number StateVA

VIII. Authorized Official

Name: SADIA MASOOD
Title or Position: PRESIDENT
Credential: MD
Phone: 301-742-1704