Individual
DR. TAREQ MASSIMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7723 SPOLETO LN, MC LEAN, VA 22102-4787
(413) 885-6942
Mailing address
7723 SPOLETO LN, MC LEAN, VA 22102-4787
(413) 885-6942
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
233575
MA
2086S0129X
Vascular Surgery Physician
102688
DC
2086S0129X
Vascular Surgery Physician
Primary
247016
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-
-
—
Enumeration date
05/27/2008
Last updated
08/17/2021
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