Individual
TAREQ ABEDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19415 DEERFIELD AVE, SUITE 213, LEESBURG, VA 20176-8470
(703) 729-9220
(703) 858-3529
Mailing address
224-D CORNWALL ST. NW SUITE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101053554
VA
208000000X
Pediatrics Physician
0101053554
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336109610
—
VA
05
—
30016730320001
—
VA
Enumeration date
03/23/2006
Last updated
10/09/2023
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