Organization
FAIRFAX FAMILY PRACTICE
Active
Other names
AFC URGENT CARE AND FAMILY CARE
Organization subpart
No
Provider details
NPI number
Authorized official
AHMAD NUSRAT (PRESIDENT)
(703) 507-7505
Entity
Organization
Contact information
Practice address
334 ELDEN ST, HERNDON, VA 20170-4818
(571) 665-4000
(571) 665-4003
Mailing address
19182 CHARTIER DR, LEESBURG, VA 20176-1622
(703) 507-7505
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
12/29/2014
Last updated
11/09/2016
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