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Individual

MOHAMMED ASHIQ MANNAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3300 GALLOWS RD, DEPARTMENT OF MEDICINE, FALLS CHURCH, VA 22042-3307
(703) 776-3582
Mailing address
3300 GALLOWS RD, DEPARTMENT OF MEDICINE, FALLS CHURCH, VA 22042-3307
(703) 776-3582

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101237447
VA
208M00000X
Hospitalist Physician
0101237447
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
232359401
GREAT VALLEY HEALTH
PA
Enumeration date
11/02/2005
Last updated
10/17/2022
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