MEDICARE: ARIAN AHMADZAI P.A.

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	363AM0700X	Medical Physician Assistant	C0001974	MD
2	363AM0700X	Medical Physician Assistant	0110008984	VA

General Provider Information

NPI Number	:	1972599272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIAN AHMADZAI P.A.

Provider Business Mailing Address
First Line	:	7503 SURRATTS RD
Second Line	:
City	:	CLINTON
State	:	MD
Zip	:	20735-3358
Country	:	US
Telephone Number	:	301-870-7001
Fax Number	:	301-870-6697

Provider Business Practice Location Address
First Line	:	14087 RICHMOND HWY UNIT 101
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191-2171
Country	:	US
Telephone Number	:	571-300-8000
Fax Number	:	571-300-8000

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

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	02/28/2025

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Directions to “ ARIAN AHMADZAI P.A.” Practice Location

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