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General NPI Number Information
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NPI Number | 1255475380
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Entity Type | Organization
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Legal Business Name | AFK LLC
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9452 MAIN STREET MED FIRST URGENT CARE
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City | FAIRFAX
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State | VA
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Zip | 22031
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Country | US
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Telephone | 703-503-1112
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Fax | 703-503-1154
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Provider Business Mailing Address
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Address Line | 9452 MAIN STREET MED FIRST URGENT CARE
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City | FAIRFAX
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State | VA
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Zip | 22031
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Country | US
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Telephone | 703-503-1112
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Fax | 703-503-1154
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Authorized Official
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Title or Position | CO OWNER
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Name | ALI AHMAD KHORRAMI
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Credential | MD
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Telephone | 703-503-1112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 105539
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License Number State | VA
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