MEDICARE: LIQAA SAID AL-KHOZAIE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	0101236747	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063514552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIQAA SAID AL-KHOZAIE MD

Provider Business Mailing Address
First Line	:	14914 RICHMOND HWY
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191
Country	:	US
Telephone Number	:	703-499-9490
Fax Number	:	703-499-9491

Provider Business Practice Location Address
First Line	:	14914 JEFFERSON DAVIS HWY
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191-4016
Country	:	US
Telephone Number	:	703-499-9490
Fax Number	:	703-499-9491

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2006
Last Update Date	:	06/10/2022

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