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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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