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Individual

AZHAR IMAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3930 PENDER DR STE 350, FAIRFAX, VA 22030-0989
(703) 865-8686
Mailing address
3930 PENDER DR STE 350, FAIRFAX, VA 22030-0989
(703) 865-8686

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101285977
VA
2084P0800X
Psychiatry Physician
042814
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001428144
CT
Enumeration date
05/19/2006
Last updated
08/12/2025
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