Organization
VIRGINIA MENTAL HEALTH INC
Active
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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