Healthcare Provider Details

I. General information

NPI: 1982776217
Provider Name (Legal Business Name): ASHBURN STERLING INTERNAL MEDICINE AND PEDIATRICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 07/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19415 DEERFIELD AVE SUITE 213
LANSDOWNE VA
20176-8452
US

IV. Provider business mailing address

19415 DEERFIELD AVE SUITE 213
LANSDOWNE VA
20176-8452
US

V. Phone/Fax

Practice location:
  • Phone: 703-729-9220
  • Fax: 703-858-3529
Mailing address:
  • Phone: 703-729-9220
  • Fax: 703-858-3529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TAREQ ABEDIN
Title or Position: OWNER
Credential: MD
Phone: 703-729-9220