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General NPI Number Information
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NPI Number | 1063469393
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Entity Type | Individual
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Provider Name | SOHAIL K MIRZA M.D., M.P.H.
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Gender | Male
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 4250 CHAIN BRIDGE RD
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City | FAIRFAX
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State | VA
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Zip | 22030-4214
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Country | US
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Telephone | 703-828-6579
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Fax | 571-458-7336
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Provider Business Mailing Address
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Address Line | 4250 CHAIN BRIDGE RD
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City | FAIRFAX
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State | VA
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Zip | 22030-4214
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Country | US
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Telephone | 703-828-6579
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Fax | 571-458-7336
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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 | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 79228
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 14258
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 0101261117
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 79154 8002
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 34710
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License Number State | CO
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Taxonomy #6
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | MD00031150
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License Number State | WA
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