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General NPI Number Information
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NPI Number | 1013010180
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Entity Type | Individual
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Provider Name | ALI JADIDI MD
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Gender | Male
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 14904 JEFFERSON DAVIS HWY SUITE 207
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City | WOODBRIDGE
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State | VA
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Zip | 22191-3311
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Country | US
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Telephone | 703-492-1400
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Fax | 703-492-0220
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Provider Business Mailing Address
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Address Line | 14904 JEFFERSON DAVIS HIGHWAY STE 207
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City | WOODBRIDGE
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State | VA
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Zip | 22191-3908
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Country | US
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Telephone | 703-492-1400
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Fax | 703-492-0220
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 0101230761
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License Number State | VA
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