Organization
AVICENNA MEDICAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SATAR AHMADI M.D., M.P.H. (PRINCIPAL)
(703) 751-7331
Entity
Organization
Contact information
Practice address
50 S PICKETT STREET, SUITE # 221, ALEXANDRIA, VA 22304-2922
(703) 751-7331
(703) 751-2524
Mailing address
50 S PICKETT ST, SUITE # 221, ALEXANDRIA, VA 22304-7207
(703) 751-7331
(703) 751-2524
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
0101041949
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005623626
—
VA
Enumeration date
08/20/2006
Last updated
11/03/2010
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