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General NPI Number Information
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NPI Number | 1891874863
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Entity Type | Individual
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Provider Name | MOHAMMAD A. ANSARI M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 03/10/2016
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Provider Practice Location Address
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Address Line | 7969 ASHTON AVE
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City | MANASSAS
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State | VA
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Zip | 20109-2885
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Country | US
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Telephone | 703-792-7800
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Fax | 703-792-4757
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Provider Business Mailing Address
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Address Line | 7969 ASHTON AVE
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City | MANASSAS
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State | VA
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Zip | 20109-2885
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Country | US
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Telephone | 703-792-7800
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Fax | 703-792-7817
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | D0063308
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License Number State | MD
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