NPI Code Details Logo

NPI 1710890397

NPI 1710890397 : PEARL MEDICAL VIRGINIA LLC : STERLING, VA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1710890397
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    PEARL MEDICAL VIRGINIA LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    09/24/2026
-----------------------------------------------------
    Last Update Date     |    09/24/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    506 SHAW RD STE 319 
-----------------------------------------------------
    City                 |    STERLING
-----------------------------------------------------
    State                |    VA
-----------------------------------------------------
    Zip                  |    20166-9445
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    307-289-2158
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    506 SHAW RD STE 319 
-----------------------------------------------------
    City                 |    STERLING
-----------------------------------------------------
    State                |    VA
-----------------------------------------------------
    Zip                  |    20166-9445
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    307-289-2158
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     SHEHZAD  KHAN 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    307-289-2158
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    207R00000X
-----------------------------------------------------
    Taxonomy Name        |    Internal Medicine Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.