Healthcare Provider Details

I. General information

NPI: 1639089634
Provider Name (Legal Business Name): MERIDIAN PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 DEVILS REACH RD
WOODBRIDGE VA
22192-2825
US

IV. Provider business mailing address

1316 DEVILS REACH RD
WOODBRIDGE VA
22192-2825
US

V. Phone/Fax

Practice location:
  • Phone: 571-307-8727
  • Fax:
Mailing address:
  • Phone: 571-307-8727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SHAHZEB IQBAL
Title or Position: CE0
Credential:
Phone: 571-307-8726