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General NPI Number Information
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NPI Number | 1265791297
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Entity Type | Organization
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Legal Business Name | VASCULAR SURGERY GROUP
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Dates
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Enumeration Date | 05/11/2012
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Last Update Date | 05/11/2012
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Provider Practice Location Address
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Address Line | 850 CHISTENSEN COURT
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City | GREAT FALLS
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State | VA
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Zip | 22066
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Country | US
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Telephone | 703-793-9720
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Fax | 703-433-1852
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Provider Business Mailing Address
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Address Line | 850 CHRISTENSEN CT
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City | GREAT FALLS
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State | VA
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Zip | 22066-1337
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Country | US
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Telephone | 703-793-9720
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Fax | 703-433-1852
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. MASEER ABDULLAH BADE
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Credential | MD
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Telephone | 703-793-9720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 0101238644
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License Number State | VA
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