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General NPI Number Information
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NPI Number | 1124517636
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Entity Type | Individual
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Provider Name | HIBA TUR RAFIQ
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Gender | Male
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Dates
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Enumeration Date | 05/09/2018
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Last Update Date | 05/09/2018
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Provider Practice Location Address
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Address Line | 117 AUSTIN DR
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City | STAFFORD
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State | VA
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Zip | 22556-1332
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Country | US
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Telephone | 540-779-0211
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Fax | 540-779-0218
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Provider Business Mailing Address
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Address Line | 117 AUSTIN DR
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City | STAFFORD
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State | VA
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Zip | 22556-1332
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Country | US
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Telephone | 540-779-0211
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Fax | 540-779-0218
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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 | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | E1518071
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License Number State |
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Taxonomy #2
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number | T67345169
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License Number State | VA
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