Healthcare Provider Details

I. General information

NPI: 1699303610
Provider Name (Legal Business Name): MUHAMMAD ABDULLAH SHAMIM DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 HOSPITAL CENTER BLVD STE 221
STAFFORD VA
22554-6203
US

IV. Provider business mailing address

1340 CENTRAL PARK BLVD STE 100
FREDERICKSBURG VA
22401-4940
US

V. Phone/Fax

Practice location:
  • Phone: 540-899-3595
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number0102209377
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: