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Organization

EDNAN MUSHTAQ MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EDNAN MUSHTAQ M.D. (PHYSICIAN)
(703) 448-0005
Entity
Organization

Contact information

Practice address
6845 ELM ST, SUITE 303, MC LEAN, VA 22101-6007
(703) 448-0005
(703) 448-0808
Mailing address
6845 ELM ST, SUITE 303, MC LEAN, VA 22101-6007
(703) 448-0005
(703) 448-0808

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0101055447
VA
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
0101055447
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006503535
VA
Enumeration date
08/21/2007
Last updated
08/21/2007
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