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Organization

EVERGREEN NEUROLOGY AND SLEEP CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ISHTIAQ AHMAD MD (CEO)
(703) 389-9712
Entity
Organization

Contact information

Practice address
8609 SUDLEY RD STE 204, MANASSAS, VA 20110-4500
(703) 348-7207
(703) 435-1844
Mailing address
8609 SUDLEY RD STE 204, MANASSAS, VA 20110-4500
(703) 348-7207
(703) 435-1844

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
0101260753
VA

Other

Enumeration date
05/07/2018
Last updated
05/07/2018
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