Healthcare Provider Details

I. General information

NPI: 1679731467
Provider Name (Legal Business Name): SHAFIC ABDULLAH SRAJ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2008
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1870 AMHERST ST STE 2B
WINCHESTER VA
22601-2841
US

IV. Provider business mailing address

220 CAMPUS BLVD STE 320
WINCHESTER VA
22601-2889
US

V. Phone/Fax

Practice location:
  • Phone: 540-536-7790
  • Fax: 540-536-7789
Mailing address:
  • Phone: 540-536-5100
  • Fax: 540-536-0235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number0101287380
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number24178
License Number StateWV
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number0101287380
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number24178
License Number StateWV
# 5
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number24178
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: