Healthcare Provider Details

I. General information

NPI: 1093765646
Provider Name (Legal Business Name): HUSSIEN A AL-SHAMMAA M. D.,F.A.A.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9705 LIBERIA AVE
MANASSAS VA
20110-1743
US

IV. Provider business mailing address

3350 COMMISSION CT
WOODBRIDGE VA
22192-1784
US

V. Phone/Fax

Practice location:
  • Phone: 703-680-7950
  • Fax:
Mailing address:
  • Phone: 703-680-7950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101049497
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number0101049497
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: