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Individual

DR. TAHMINA HAQUE BRADY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
16890 FOREST RD, FOREST, VA 24551-4059
(202) 714-1174
Mailing address
922 MAIN ST APT 403, LYNCHBURG, VA 24504-1626
(202) 714-1174

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101265635
VA
390200000X
Student in an Organized Health Care Education/Training Program
0116028644
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
207Q00000X
FAMILY MEDICINE
VA
Enumeration date
07/06/2015
Last updated
12/01/2018
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