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General NPI Number Information
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NPI Number | 1184301418
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Entity Type | Organization
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Legal Business Name | NABA MEDICAL, P.C.
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Dates
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Enumeration Date | 06/29/2023
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Last Update Date | 01/11/2025
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Provider Practice Location Address
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Address Line | 1751 PINNACLE DR STE 600
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City | TYSONS
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State | VA
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Zip | 22102-4007
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Country | US
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Telephone | 703-810-7221
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Fax | 571-601-2803
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Provider Business Mailing Address
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Address Line | 5342 WOODBURY WOODS PL
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City | FAIRFAX
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State | VA
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Zip | 22032-3729
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. OMAR ALI USMAN
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Credential | MD
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Telephone | 248-767-9656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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