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General NPI Number Information
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NPI Number | 1336324870
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Entity Type | Organization
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Legal Business Name | AMMAR MEDICAL CENTER. LLC
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Dates
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Enumeration Date | 01/03/2008
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Last Update Date | 10/16/2008
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Provider Practice Location Address
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Address Line | 4040 N FAIRFAX DR
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City | ARLINGTON
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State | VA
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Zip | 22203-1811
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Country | US
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Telephone | 703-981-1898
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Fax | 703-564-5618
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Provider Business Mailing Address
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Address Line | 14231 OAKPOINTE DR
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City | LAUREL
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State | MD
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Zip | 20707-5865
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Country | US
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Telephone | 410-662-1535
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KHAWAJA ATIF FAROOQ
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Credential | M.D.
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Telephone | 703-981-1898
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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 | 0101242663
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License Number State | VA
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