Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 01082398A | IN |
Y | 208200000X | Surgeon | 0101271338 | VA |
Y | 208600000X | Surgeon | 0101271338 | VA |
NPI | 1083038558 |
---|---|
Provider Name | Ahmad Safra |
First Address | Baltimore, MD 21297-3174 |
Second Address | Falls Church, VA 22042-3307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2014 |
Last Update Date | 06/03/2021 |