=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598075913
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABRAHAM MAHINI MDPC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/19/2010
-----------------------------------------------------
Last Update Date | 11/18/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 700 INDEPENDENCE CIR SUITE2C
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23455-6405
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-499-3500
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 700 INDEPENDENCE CIR SUITE2C
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23455-6405
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-499-3500
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. ABRAHAM NMN MAHINI
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 757-499-3500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------