Organization
PW UROLOGY OBS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI SAJADI (MEDICAL DIRECTOR)
(703) 361-4129
Entity
Organization
Contact information
Practice address
9580 SURVEYOR CT, MANASSAS, VA 20110-4406
(703) 361-4129
(703) 361-9442
Mailing address
9580 SURVEYOR CT, MANASSAS, VA 20110-4406
(703) 361-4129
(703) 361-9442
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010198976
—
VA
01
—
014761
ANTHEM BC/BS
VA
01
—
182822
ANTHEM BC/BS
VA
01
—
281216
AMERIGROUP
VA
01
—
306085
ANTHEM BC/BS
VA
01
—
4274185
AETNA
VA
05
—
7510306
—
VA
01
—
7685401
AETNA
VA
01
—
7966591
AETNA
VA
01
—
87830002
CAREFIRST BC/BS
VA
01
—
87830004
CAREFIRST BC/BS
VA
01
—
87830005
CAREFIRST BC/BS
VA
Enumeration date
05/15/2009
Last updated
05/15/2009
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