Organization
VIRGINIA MENTAL HEALTH INC
Active
Other names
Fairfax Psychiatry PC
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHNOOR ALI KHAN MD (PRESIDENT)
(703) 400-3433
Entity
Organization
Contact information
Practice address
1800 MICHAEL FARADAY DR STE 206, RESTON, VA 20190-5312
(888) 237-5426
(703) 763-2350
Mailing address
11123 COROBON LN, GREAT FALLS, VA 22066-1403
(304) 279-9772
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101235819
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101235819
STATE MEDICAL LICENSE
VA
Enumeration date
09/25/2006
Last updated
12/14/2023
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