Individual
DR. HANIBAL MAHDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
305 MAPLE AVE W STE A, VIENNA, VA 22180-4306
(571) 407-7004
(571) 407-7092
Mailing address
305 MAPLE AVE W STE A, VIENNA, VA 22180-4306
(571) 407-7004
(571) 407-7092
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101056882
VA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
0101056882
VA
207R00000X
Internal Medicine Physician
Primary
0101056882
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010031834
—
VA
05
—
1891753406
—
VA
05
—
1891753406
—
WV
01
—
267139
BLUE SHIELD
VA
05
—
5886325
—
VA
01
—
P00023208
RAILROAD MEDICARE
VA
Enumeration date
05/03/2006
Last updated
11/14/2023
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