Individual
TAJAMMUL EHSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
722 GRANT ST, STE. F, HERNDON, VA 20170-4532
(703) 787-7638
(703) 787-7654
Mailing address
722 GRANT ST, STE. F, HERNDON, VA 20170-4532
(703) 787-7638
(703) 787-7654
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
0101232388
VA
2084N0600X
Clinical Neurophysiology Physician
0101232388
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7117787
—
VA
Enumeration date
09/26/2006
Last updated
06/23/2008
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