Healthcare Provider Details
I. General information
NPI: 1861310807
Provider Name (Legal Business Name): BAYASI SURGICAL ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1850 TOWN CENTER PKWY STE 310
RESTON VA
20190-3300
US
IV. Provider business mailing address
1850 TOWN CENTER PKWY STE 310
RESTON VA
20190-3300
US
V. Phone/Fax
- Phone: 705-570-5227
- Fax:
- Phone: 705-570-5227
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MOHAMMED
BAYASI
Title or Position: MANAGER
Credential: MD
Phone: 703-570-5227