Individual
SHAMIM AKHTAR IMAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
504 ELDEN ST # 3, HERNDON, VA 20170-4741
(703) 471-0800
(703) 471-1332
Mailing address
504 ELDEN ST # 3, HERNDON, VA 20170-4741
(703) 471-0800
(703) 471-1332
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101046800
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005611377
—
VA
Enumeration date
10/17/2006
Last updated
02/21/2014
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