{
"Npi": {
"NPI": "1669676250",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ABEDIN",
"FirstName": "SHAAD",
"MiddleName": "ESSA",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD FACP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "ABDULLAH",
"OtherFirstName": "SHAAD",
"OtherMiddleName": "ESSA",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "MD FACP",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "405 CHATHAM HEIGHTS RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FREDERICKSBURG",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22405-2582",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "540-300-1602",
"MailingAddressFaxNumber": "646-349-7620",
"FirstLinePracticeLocationAddress": "405 CHATHAM HEIGHTS RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FREDERICKSBURG",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22405-2582",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "540-300-6182",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/14/2007",
"LastUpdateDate": "01/13/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "207RH0003X",
"TaxonomyName": "Hematology & Oncology Physician",
"LicenseNumber": "MD041091",
"LicenseNumberStateCode": "DC",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207RH0003X",
"TaxonomyName": "Hematology & Oncology Physician",
"LicenseNumber": "D0074899",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207RH0003X",
"TaxonomyName": "Hematology & Oncology Physician",
"LicenseNumber": "0101252823",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}