Healthcare Provider Details

I. General information

NPI: 1245168509
Provider Name (Legal Business Name): ALLAH DAD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 OPITZ BLVD SENTARA NORTH VIRGINIA MEDICAL CENTER
WOODBRIDGE VA
22191
US

IV. Provider business mailing address

2280 OPITZ BLVD SUITE 110 GRADUATE MEDICAL EDUCATION-CORRESPONDENCE
WOODBRIDGE VA
22191
US

V. Phone/Fax

Practice location:
  • Phone: 703-523-1409
  • Fax: 571-542-9969
Mailing address:
  • Phone: 703-523-1409
  • Fax: 571-542-9969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: