OBGYN of Virginia, LLC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

0101241302 Issued in VA

Legal business name

OBGYN OF VIRGINIA, LLC

Practice address

3930 Pender Dr
Suite 60
Fairfax, VA 22030-0985

Phone

(571) 249-0717

NPI assigned

May 12, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shawana Mufti

Title

Owner

Phone

(571) 249-0717

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399852800000",
    "number": "1144631276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10351 ELIZABETH ST",
            "city": "GREAT FALLS",
            "state": "VA",
            "postal_code": "220662922",
            "telephone_number": "571-249-0717",
            "fax_number": "703-865-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 PENDER DR",
            "address_2": "SUITE 60",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220300985",
            "telephone_number": "571-249-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBGYN OF VIRGINIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-12",
        "last_updated": "2014-05-12",
        "status": "A",
        "authorized_official_last_name": "MUFTI",
        "authorized_official_first_name": "SHAWANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "571-249-0717"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "VA",
            "license": "0101241302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023237997",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gynecology Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Gynecology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.