Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RS0012X | Sleep Medicine | 0101238282 | VA |
NPI | 1275545196 |
---|---|
Provider Name | Syed J Murtaza |
First Address | Haymarket, VA 20169-6164 |
Second Address | Haymarket, VA 20169-6164 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2006 |
Last Update Date | 27/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1275545196 | (05) | VA |