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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