Healthcare Provider Details

I. General information

NPI: 1659574010
Provider Name (Legal Business Name): RAAFAT ALI SHABTI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DR. RAY SHABTI

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9420 FAIRFAX BLVD STE 4
FAIRFAX VA
22031-2406
US

IV. Provider business mailing address

9420 FAIRFAX BLVD STE 4
FAIRFAX VA
22031-2406
US

V. Phone/Fax

Practice location:
  • Phone: 703-565-1823
  • Fax: 833-471-4157
Mailing address:
  • Phone: 703-565-1823
  • Fax: 833-471-4157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2007-00064
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101057738
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: