Organization
NORTHERN VIRGINIA GASTROENTEROLOGY AND HEPATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMIRA Z ALI IBRAHIM M.D. (OWNER AND SOLO PRACTITIONER)
(301) 613-6351
Entity
Organization
Contact information
Practice address
5254 DAWES AVE, ALEXANDRIA, VA 22311-1404
(301) 613-6351
Mailing address
10102 E LAKE DR, FAIRFAX, VA 22032-2732
(301) 613-6351
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101244137
VA
Other
Enumeration date
09/26/2010
Last updated
09/26/2010
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