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General NPI Number Information
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NPI Number | 1417300054
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Entity Type | Organization
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Legal Business Name | NABEELA TABASSUM MD PC
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Dates
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Enumeration Date | 07/19/2016
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Last Update Date | 07/19/2016
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Provider Practice Location Address
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Address Line | 4810 BEAUREGARD ST SUITE 303
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City | ALEXANDRIA
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State | VA
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Zip | 22312-1709
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Country | US
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Telephone | 703-750-0108
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Fax |
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Provider Business Mailing Address
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Address Line | 4810 BEAUREGARD ST SUITE 303
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City | ALEXANDRIA
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State | VA
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Zip | 22312-1709
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Country | US
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Telephone | 703-750-0108
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | NABEELA TABASSUM
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Credential | M.D.
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Telephone | 703-750-0108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101249396
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License Number State | VA
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