Organization
MID ATLANTIC MEDICAL ASSOCIATES, LLC
Active
Other names
MAMA Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAFEEK SEDDIQ ESQ. (MEMBER)
(703) 677-6394
Entity
Organization
Contact information
Practice address
10604 ROSEHAVEN ST, FAIRFAX, VA 22030-2825
(703) 627-9930
Mailing address
10604 ROSEHAVEN ST, FAIRFAX, VA 22030-2825
(703) 627-9930
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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