Individual
HIRA AZAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25401 EASTERN MARKETPLACE PLZ, CHANTILLY, VA 20152-5782
(703) 722-2126
Mailing address
5922 BARON KENT LN, CENTREVILLE, VA 20120-3437
(913) 963-3988
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202219907
VA
Other
Enumeration date
01/24/2022
Last updated
01/24/2022
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