Healthcare Provider Details

I. General information

NPI: 1508784067
Provider Name (Legal Business Name): IMRAN MASIH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8713 CLAYMONT DR APT A
HENRICO VA
23229-4040
US

IV. Provider business mailing address

8713 CLAYMONT DR APT A
HENRICO VA
23229-4040
US

V. Phone/Fax

Practice location:
  • Phone: 820-465-6295
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: